Individual provider · Type 1 NPI
Marie Ann Shade, LCPC
Addiction (Substance Use Disorder) Counselor · Boise, ID
NPI number
1609945831
Active
Practice location
684 N 9th Street
Boise, ID 85702-5458
Fax (208) 389-1474
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | LCPC44 (ID) |
| Mental Health Counselor | 101YM0800X | LCPC44 (ID) |
| Professional Counselor | 101YP2500X | LCPC44 (ID) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
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About NPI 1609945831
Marie Ann Shade, LCPC's National Provider Identifier is 1609945831, issued on Nov 6, 2006. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Boise, ID. The record was last updated on Sep 11, 2025.