SHASTA WEASE - NPI 1255057402 - Peer Specialist in Elizabethtown, KY

Q: What is Shasta Wease's NPI number?

The NPI number for Shasta Wease is 1255057402. It was assigned to this individual provider in the NPPES registry on October 18, 2022.

Q: What is Shasta Wease's specialty?

The primary specialty registered for this NPI is Peer Specialist with taxonomy code 175T00000X.

Q: When was this NPI record last updated?

The NPPES record for Shasta Wease was last updated on October 18, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Shasta Wease NPPES

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

SHASTA WEASE (NPI 1255057402) is an individual peer specialist in Elizabethtown, Kentucky and active in the NPI registry since October 2022.

NPPES Registry Identity

NPI1255057402

Entity TypeIndividualFemale

Primary Taxonomy175T00000X

Provider Legal NameSHASTA WEASE

Location Address907 N MULBERRY ST STE 200Elizabethtown, KY 42701-2018

Mailing Address2810 Frontier Ct Apt 1Radcliff, KY 40160-9075 · (502) 353-8277 · Fax (270) 982-7372

Phone(270) 982-7372

Fax(270) 982-7372

Sole ProprietorNo

Enumeration DateOctober 18, 2022

NPPES CertifiedOctober 18, 2022

✔ NPI 1255057402 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPeer SpecialistOther Service Providers

Taxonomy Code175T00000X

Definition

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

907 N MULBERRY ST STE 200, Elizabethtown, KY 42701

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Other Providers at the Same Location NPPES 11

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

AMBER BRITTANY DUKE

Peer Specialist