Individual
MR. SHAWN EDMONTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CASAC-T
Contact information
Practice address
2367-69 SECOND AVENUE, NEW YORK, NY 10035
(212) 876-2300
(212) 722-7618
Mailing address
70 MALCOLM X BLVD, APT. 11J, NEW YORK, NY 10026-3001
(212) 876-2300
(212) 722-7618
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
31064
NY
Other
Enumeration date
05/18/2016
Last updated
05/18/2016
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