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General NPI Number Information
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NPI Number | 1386113918
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Entity Type | Individual
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Provider Name | SHAVONNA LASHAY PRICE CDCA
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Gender | Female
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Dates
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Enumeration Date | 11/13/2018
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Last Update Date | 01/28/2025
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Provider Practice Location Address
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Address Line | 10400 BLACKLICK EASTERN RD
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City | PICKERINGTON
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State | OH
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Zip | 43147-8235
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Country | US
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Telephone | 614-726-7359
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Fax |
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Provider Business Mailing Address
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Address Line | 115 S REYNOLDS RD
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City | TOLEDO
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State | OH
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Zip | 43615-6958
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Country | US
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Telephone | 419-725-6631
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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 | CDCD.165329
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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 |
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