MEDICARE: SHANNON CABE LCDC II

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	LCDCII.162153	OH
2	171M00000X	Case Manager/Care Coordinator

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386320075
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANNON CABE LCDC II

Provider Business Mailing Address
First Line	:	31010 TOWNSHIP ROAD 25
Second Line	:
City	:	WARSAW
State	:	OH
Zip	:	43844-9450
Country	:	US
Telephone Number	:	740-502-6739
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 E STATE ST
Second Line	:
City	:	ATHENS
State	:	OH
Zip	:	45701-1856
Country	:	US
Telephone Number	:	866-534-2639
Fax Number	:	800-480-7578

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

Provider Enumeration Date	:	06/26/2023
Last Update Date	:	03/04/2026

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