MEDICARE: SHANNA CHAMBERLAIN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	175T00000X	Peer Specialist	PRS.007683	OH

General Provider Information

NPI Number	:	1184551764
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANNA CHAMBERLAIN

Provider Business Mailing Address
First Line	:	8044 MONTGOMERY RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45236-2919
Country	:	US
Telephone Number	:	513-607-5128
Fax Number	:

Provider Business Practice Location Address
First Line	:	119 CENTER ST
Second Line	:
City	:	PLAIN CITY
State	:	OH
Zip	:	43064-1101
Country	:	US
Telephone Number	:	513-607-5128
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/06/2026
Last Update Date	:	05/06/2026

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Directions to “ SHANNA CHAMBERLAIN ” Practice Location

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