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General NPI Number Information
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NPI Number | 1780830281
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Entity Type | Individual
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Provider Name | FRIDONNA LEIGH SHEPARD-STEELE CADC
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Gender | Female
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Dates
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Enumeration Date | 08/15/2008
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Last Update Date | 02/22/2022
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Provider Practice Location Address
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Address Line | HIGHWAY 491 NORTH PINON & COTTONWOOD DR. BUILDING 2301
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City | SHIPROCK
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State | NM
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Zip | 87420
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Country | US
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Telephone | 505-368-1439
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Fax |
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Provider Business Mailing Address
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Address Line | 284 EXECUTIVE PARK DR SUITE 100
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City | CONCORD
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State | NC
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Zip | 28025-1831
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Country | US
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Telephone |
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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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 | 2003
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License Number State | NM
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Taxonomy #3
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CADC-21647
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License Number State | NC
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