Healthcare Provider Details

I. General information

NPI: 1912281049
Provider Name (Legal Business Name): SHANNON M LEPE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2011
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1460 S CURRY ST
CARSON CITY NV
89703-5100
US

IV. Provider business mailing address

4966 CAVESTONE RD
SUN VALLEY NV
89433-8233
US

V. Phone/Fax

Practice location:
  • Phone: 775-617-5605
  • Fax:
Mailing address:
  • Phone: 775-671-5605
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number08134-I
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: