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General NPI Number Information
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NPI Number | 1376924696
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Entity Type | Individual
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Provider Name | RENEE A SHEA LMFT, CADC
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Gender | Female
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Dates
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Enumeration Date | 06/11/2015
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Last Update Date | 11/02/2022
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Provider Practice Location Address
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Address Line | 477 E BUTTERFIELD RD STE 310-5
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City | LOMBARD
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State | IL
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Zip | 60148-5618
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Country | US
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Telephone | 630-426-9279
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Fax |
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Provider Business Mailing Address
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Address Line | 477 E BUTTERFIELD RD STE 310-5
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City | LOMBARD
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State | IL
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Zip | 60148-5618
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Country | US
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Telephone | 630-426-9279
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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 | 30982
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 166000977
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License Number State | IL
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