Healthcare Provider Details

I. General information

NPI: 1225712045
Provider Name (Legal Business Name): SHANA SAMANTHA PLOUNT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2023
Last Update Date: 02/28/2025
Certification Date: 02/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 N ADA ST
FALLON NV
89406-2906
US

IV. Provider business mailing address

2040 RENO HWY STE 433
FALLON NV
89406-2772
US

V. Phone/Fax

Practice location:
  • Phone: 775-404-5444
  • Fax:
Mailing address:
  • Phone: 775-404-5444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number00841-C
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number9226-M
License Number StateNV
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberIC-1734
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: