Individual provider · Type 1 NPI

Shandi Lynn Ellis

Addiction (Substance Use Disorder) Counselor · Augusta, ME

NPI number 1104631019 Active

Practice location

10 Caldwell Rd
Augusta, ME 04330-5735

Mailing address

22 North St Apt 3
Augusta, ME 04330-5009

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XCAC8759 (ME)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1104631019

Shandi Lynn Ellis's National Provider Identifier is 1104631019, issued on Feb 8, 2025. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Augusta, ME. The record was last updated on Feb 8, 2025.