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SHANE BASTAR SAC-IT
NPI 1457044000
Counselor - Addiction (Substance Use Disorder) in Green Bay, WI

Active since May 31, 2023
2357 W MASON ST, GREEN BAY, WI 54303(920) 337-6740 Get Directions Write a Review

NPPES record last updated: May 31, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Shane Bastar Sac-it NPPES

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

SHANE BASTAR SAC-IT (NPI 1457044000) is an individual addiction (substance use disorder) provider in Green Bay, Wisconsin, licensed in Wisconsin (20212-130) and active in the NPI registry since May 2023.

NPPES Registry Identity

NPI1457044000
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameSHANE BASTARCredential: SAC-IT
Location Address2357 W MASON STGreen Bay, WI 54303-4708
Mailing Address2357 W Mason StGreen Bay, WI 54303-4708 · (920) 337-6740
Phone(920) 337-6740
Sole ProprietorYes
Enumeration DateMay 31, 2023
NPPES CertifiedMay 31, 2023
✔ NPI 1457044000 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in WI · 20212-130
2357 W MASON ST, Green Bay, WI 54303
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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.

JENNIFER STRADER
Counselor (Addiction (Substance Use Disorder))
2357 W MASON ST
GREEN BAY, WI 54303
Brown County (920) 337-6740
ROGER P SMITH
Counselor (Addiction (Substance Use Disorder))
2357 W MASON ST
GREEN BAY, WI 54303
Brown County (920) 337-6740
ALYSSA BALDWIN
Licensed Practical Nurse
2357 W MASON ST
GREEN BAY, WI 54303
Brown County (920) 337-6740
KELLY CHRISMAN
Licensed Practical Nurse
2357 W MASON ST
GREEN BAY, WI 54303
Brown County (920) 337-6740
JAMIE THEISEN SAC-IT
Counselor (Addiction (Substance Use Disorder))
2357 W MASON ST
GREEN BAY, WI 54303
Brown County (920) 337-6740
AMY RETLICK SAC-IT
Counselor (Addiction (Substance Use Disorder))
2357 W MASON ST
GREEN BAY, WI 54303
Brown County (920) 337-6740
DAVID WALTER KINGSFIELD CSAC CSIT
Counselor (Addiction (Substance Use Disorder))
2357 W MASON ST
GREEN BAY, WI 54303
Brown County (920) 337-6740
LINDSEY DAVIS SAC-IT 18487-130
Counselor (Addiction (Substance Use Disorder))
2357 W MASON ST
GREEN BAY, WI 54303
Brown County (920) 337-6740

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 Shane Bastar's NPI number?

The NPI number for Shane Bastar is 1457044000. It was assigned to this individual provider in the NPPES registry on May 31, 2023.

Where is Shane Bastar located?

Shane Bastar practices at 2357 W Mason St, Green Bay, WI 54303. The listed phone number is (920) 337-6740.

What is Shane Bastar's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Shane Bastar was last updated on May 31, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.