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General NPI Number Information
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NPI Number | 1437632759
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Entity Type | Individual
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Provider Name | SHANE MICHAEL SATTERFIELD MSW, LSW, LICDC
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Gender | Male
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Dates
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Enumeration Date | 09/12/2018
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Last Update Date | 02/05/2023
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Provider Practice Location Address
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Address Line | 3153 SOVEREIGN DR
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City | CINCINNATI
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State | OH
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Zip | 45251-3160
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Country | US
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Telephone | 513-410-8142
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Fax | 513-407-6918
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Provider Business Mailing Address
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Address Line | 3153 SOVEREIGN DR
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City | CINCINNATI
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State | OH
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Zip | 45251-3160
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Country | US
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Telephone | 513-410-8142
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Fax | 513-407-6918
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | S.1700057
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LICDC.162128
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License Number State | OH
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