Individual
SHAWNA THACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC
Contact information
Practice address
368 S MAYO TRL, PIKEVILLE, KY 41501-1522
(606) 437-0047
(606) 437-0547
Mailing address
368 S MAYO TRL, PIKEVILLE, KY 41501-1522
(606) 437-0047
(606) 437-0547
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
ADCADC00216716
KY
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
02/24/2015
Last updated
12/15/2015
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