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NPI Code Detail

MEDICARE: SHAWN WHISMAN CDCA

MEDICARE: SHAWN WHISMAN CDCA
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
1171M00000XCase Manager/Care CoordinatorCMS
2101YA0400XAddiction (Substance Use Disorder) CounselorCDCA.175455OH
3101YM0800XMental Health CounselorQMHS

Other Identifiers

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

General Provider Information

NPI Number : 1760971949
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHAWN WHISMAN CDCA
Provider Business Mailing Address
First Line : PO BOX 402
Second Line :
City : WHEELERSBURG
State : OH
Zip : 45694-0402
Country : US
Telephone Number : 740-858-6683
Fax Number :
Provider Business Practice Location Address
First Line : 9620 CAREYS RUN POND CREEK RD
Second Line :
City : MC DERMOTT
State : OH
Zip : 45652-3902
Country : US
Telephone Number : 740-858-6683
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2018
Last Update Date : 12/08/2023

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Directions to “ SHAWN WHISMAN CDCA” Practice Location

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