MEDICARE: SHANNON MARIE BRADSHAW

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

General Provider Information

NPI Number	:	1720506769
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANNON MARIE BRADSHAW

Provider Business Mailing Address
First Line	:	896 THOMAS RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43212-3717
Country	:	US
Telephone Number	:	614-508-2019
Fax Number	:

Provider Business Practice Location Address
First Line	:	751 NORTHWEST BLVD STE 200
Second Line	:
City	:	GRANDVIEW
State	:	OH
Zip	:	43212-1977
Country	:	US
Telephone Number	:	614-783-6010
Fax Number	:

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

Provider Enumeration Date	:	08/30/2017
Last Update Date	:	09/11/2025

Similar Medicare Providers

1164150389 — COURTNEY MONTANYE CT
Practice Location Address:

751 NORTHWEST BLVD STE 200
GRANDVIEW, OH
43212-1977

Practice Phone: 614-783-6010
Practice Fax:

1407715923 — THEMBA MSISHA
Practice Location Address:

751 NORTHWEST BLVD STE 200
GRANDVIEW, OH
43212-1977

Practice Phone: 740-860-9943
Practice Fax:

1215990775 — KATHY A HORAVA DO
Practice Location Address:

1125 YARD ST STE 250
GRANDVIEW HEIGHTS, OH
43212-3930

Practice Phone: 614-788-8150
Practice Fax:

1356307094 — DR. AYSER C HAMOUDI MD
Practice Location Address:

1480 GRANDVIEW AVE
COLUMBUS, OH
43212

Practice Phone: 614-486-9461
Practice Fax: 614-486-2318

1396799391 — MARYELLEN SWARTZ LUEBBERS O.D.
Practice Location Address:

1421 GRANDVIEW AVE
COLUMBUS, OH
43212-2853

Practice Phone: 614-488-2020
Practice Fax: 614-488-0763

1063467892 — DWB, INC
Practice Location Address:

1421 GRANDVIEW AVE
COLUMBUS, OH
43212-2853

Practice Phone: 614-488-2020
Practice Fax: 614-488-0763

Directions to “ SHANNON MARIE BRADSHAW ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.