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NPI Code Detail

MEDICARE: ANN MARIE SHODDY AAC,CPC,CDPT,BAE

MEDICARE: ANN MARIE SHODDY AAC,CPC,CDPT,BAE
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
1175T00000XPeer SpecialistCG60858312WA
2101YM0800XMental Health CounselorCG60858312WA
3101YA0400XAddiction (Substance Use Disorder) CounselorCO60823685WA
4251B00000XCase Management AgencyCG60858312WA

General Provider Information

NPI Number : 1225515844
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANN MARIE SHODDY AAC,CPC,CDPT,BAE
Provider Business Mailing Address
First Line : 1302 COMMERCE AVE
Second Line :
City : LONGVIEW
State : WA
Zip : 98632-3096
Country : US
Telephone Number : 360-423-2806
Fax Number :
Provider Business Practice Location Address
First Line : 1302 COMMERCE AVE
Second Line :
City : LONGVIEW
State : WA
Zip : 98632-3096
Country : US
Telephone Number : 360-423-2806
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2018
Last Update Date : 04/06/2026

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