Individual
MR. EDWARD J. SHEA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, LAC
Contact information
Practice address
200 PULVER HALL, DICKINSON, ND 58601-4878
(701) 227-7580
(701) 227-7575
Mailing address
200 PULVER HALL, DICKINSON, ND 58601-4878
(701) 227-7580
(701) 227-7575
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1114
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09113
BCBS PIN
ND
05
—
54523
—
ND
Enumeration date
07/25/2006
Last updated
07/08/2007
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