MEDICARE: MRS. SHAMIKA SHANTE' HERRINGTON-KING CRSS

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	CRSS-55220	IL

General Provider Information

NPI Number	:	1922958651
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHAMIKA SHANTE' HERRINGTON-KING CRSS

Provider Business Mailing Address
First Line	:	2066 WOODSONG WAY LN
Second Line	:
City	:	BELLEVILLE
State	:	IL
Zip	:	62220-3292
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8 EXECUTIVE DR
Second Line	:
City	:	FAIRVIEW HEIGHTS
State	:	IL
Zip	:	62208-1345
Country	:	US
Telephone Number	:	618-688-4727
Fax Number	:

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

Provider Enumeration Date	:	02/02/2026
Last Update Date	:	02/02/2026

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