BLAIR EVONNE SHANE
NPI 1104696566
Counselor - Mental Health in Jacksonville, FL

Active since January 08, 2024
3725 BELFORT RD, JACKSONVILLE, FL 32216(904) 296-1055 Get Directions Write a Review

NPPES record last updated: February 14, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Blair Evonne Shane NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BLAIR EVONNE SHANE (NPI 1104696566) is an individual mental health provider in Jacksonville, Florida, licensed in Florida (IMH26957) and active in the NPI registry since January 2024.

NPPES Registry Identity

NPI1104696566
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameBLAIR EVONNE SHANE
Location Address3725 BELFORT RDJacksonville, FL 32216-5813
Mailing Address3725 Belfort RdJacksonville, FL 32216-5813 · (904) 296-1055
Sole ProprietorYes
Enumeration DateJanuary 8, 2024
Last NPPES UpdateFebruary 14, 2025
NPPES CertifiedFebruary 14, 2025
NPI 1104696566 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License Licensed in FL · IMH26957
3725 BELFORT RD, Jacksonville, FL 32216

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Specialist
3725 BELFORT RD
JACKSONVILLE, FL 32216
Counselor (Professional)
3725 BELFORT RD
JACKSONVILLE, FL 32216
Counselor (Mental Health)
3725 BELFORT RD
JACKSONVILLE, FL 32216
Social Worker
3725 BELFORT RD
JACKSONVILLE, FL 32216
Social Worker
3725 BELFORT RD
JACKSONVILLE, FL 32216
Counselor (Mental Health)
3725 BELFORT RD
JACKSONVILLE, FL 32216
Counselor (Mental Health)
3725 BELFORT RD
JACKSONVILLE, FL 32216
Social Worker (Clinical)
3725 BELFORT RD
JACKSONVILLE, FL 32216

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Blair Shane's NPI number?

The NPI number for Blair Shane is 1104696566. It was assigned to this individual provider in the NPPES registry on January 8, 2024.

Where is Blair Shane located?

Blair Shane practices at 3725 Belfort Rd, Jacksonville, FL 32216. The listed phone number is (904) 296-1055.

What is Blair Shane's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Blair Shane was last updated on February 14, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.