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General NPI Number Information
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NPI Number | 1669966685
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Entity Type | Individual
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Provider Name | SHAWN S ALDRIDGE LICDC
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Gender | Male
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Dates
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Enumeration Date | 06/22/2018
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Last Update Date | 07/18/2025
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Provider Practice Location Address
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Address Line | 11826 GALLIA PIKE STE C
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City | WHEELERSBURG
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State | OH
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Zip | 45694-9119
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Country | US
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Telephone | 740-876-4117
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Fax | 800-480-7578
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Provider Business Mailing Address
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Address Line | 17618 STATE ROUTE 93
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City | PEDRO
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State | OH
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Zip | 45659-8754
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Country | US
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Telephone | 740-646-5753
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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 | LICDC.162867
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License Number State | OH
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