Individual
CATHERINE SHANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
103 RACHEL CARSON WAY, ITHACA, NY 14850-9395
(828) 252-7775
Mailing address
103 RACHEL CARSON WAY, ITHACA, NY 14850-9395
(828) 252-7775
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
15972
NC
101YM0800X
Mental Health Counselor
Primary
012538
NY
101YM0800X
Mental Health Counselor
10103
NC
Other
Enumeration date
11/10/2014
Last updated
01/17/2023
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