Individual
ADAM SHANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1250 CONNECTICUT AVE NW FL 7, WASHINGTON, DC 20036-2603
(703) 209-7624
Mailing address
1250 CONNECTICUT AVE NW FL 7, WASHINGTON, DC 20036-2603
(703) 209-7624
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LC6336
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13613280
CAQH PROVIDER ID
—
Enumeration date
07/23/2015
Last updated
01/20/2022
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