Individual provider · Type 1 NPI

Shane Lee Whiteside

Peer Specialist · Oxford, MS

NPI number 1174174502 Active

Practice location

152 Highway 7 S
Oxford, MS 38655-5392

Call (662) 234-7521 Map

Fax (662) 236-3071

Mailing address

5280 County Road 220
Water Valley, MS 38965-6221

Specialties and licenses

TaxonomyCodeLicense
Peer Specialist Primary 175T00000XNone listed

Peer Specialist: Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

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About NPI 1174174502

Shane Lee Whiteside's National Provider Identifier is 1174174502, issued on Sep 26, 2019. The primary taxonomy on file is Peer Specialist (175T00000X), and the practice location is in Oxford, MS. The record was last updated on Sep 26, 2019.