MEDICARE: TRUE NORTH TREATMENT CENTER

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	103TC0700X	Clinical Psychologist	3944	AZ
2	103TC0700X	Clinical Psychologist	3822	AZ
3	101Y00000X	Counselor	13421	AZ

General Provider Information

NPI Number	:	1235456468
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRUE NORTH TREATMENT CENTER

Provider Business Mailing Address
First Line	:	PO BOX 74695
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85087-1012
Country	:	US
Telephone Number	:	888-849-4887
Fax Number	:	888-849-5696

Provider Business Practice Location Address
First Line	:	34975 N NORTH VALLEY PKWY
Second Line	:	SUITE 152
City	:	PHOENIX
State	:	AZ
Zip	:	85086-4028
Country	:	US
Telephone Number	:	888-849-4887
Fax Number	:	888-849-5696

Authorized Official
Title or Position	:	PSYCHOLOGIST
Name	:	DR. SHONA L SHEWMAKER
Credential	:	PH.D.
Telephone Number	:	888-849-4887

Provider Enumeration Date	:	04/28/2010
Last Update Date	:	07/22/2011

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Directions to “TRUE NORTH TREATMENT CENTER ” Practice Location

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