MEDICARE: SHABREE RAWLS LPC

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	101Y00000X	Counselor	C1801065-TRNE	OK
2	101Y00000X	Counselor	C.2002502	OH

General Provider Information

NPI Number	:	1992299382
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHABREE RAWLS LPC

Provider Business Mailing Address
First Line	:	1348 BROOKLINE RD APT NOA202
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44121-2570
Country	:	US
Telephone Number	:	419-961-9303
Fax Number	:

Provider Business Practice Location Address
First Line	:	1348 BROOKLINE RD APT A202
Second Line	:
City	:	CLEVELAND HTS
State	:	OH
Zip	:	44121-2586
Country	:	US
Telephone Number	:	419-961-9303
Fax Number	:

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

Provider Enumeration Date	:	06/19/2018
Last Update Date	:	10/01/2020

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