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NPI 1366955999

NPI 1366955999 : S'ENCE SHARDYNE' INMAN CDCA LL, QMHS, CMS : NEW PHILADELPHIA, OH

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General NPI Number Information
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    NPI Number           |    1366955999
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    Entity Type          |    Individual 
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    Provider Name        |    S'ENCE SHARDYNE' INMAN CDCA LL, QMHS, CMS
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/06/2017
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    Last Update Date     |    07/10/2025
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Provider Practice Location Address
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    Address Line         |    1433 5TH ST NW 
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    City                 |    NEW PHILADELPHIA
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    State                |    OH
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    Zip                  |    44663-1223
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    Country              |    US
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    Telephone            |    330-343-8171
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    343 W BAGLEY RD 
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    City                 |    BEREA
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    State                |    OH
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    Zip                  |    44017-1370
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    Country              |    US
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    Telephone            |    440-234-2006
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    101YA0400X
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    Taxonomy Name        |    Addiction (Substance Use Disorder) Counselor
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    License Number       |    CDCA.168392
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    License Number State |    OH
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Taxonomy #2
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    Taxonomy Code        |    171M00000X
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    Taxonomy Name        |    Case Manager/Care Coordinator
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    License Number       |    
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    License Number State |    OH
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Taxonomy #3
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    Taxonomy Code        |    172V00000X
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    Taxonomy Name        |    Community Health Worker
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    License Number       |    
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    License Number State |    OH
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