Shane Liedeke is a Peer Specialist based in Cassopolis, MI. Shane Liedeke practices in Cassopolis, MI. The NPI Number for Shane Liedeke is 1033971577 and holds a License No. (Michigan).
The current practice location address for Shane Liedeke is 1124 Austin, Cassopolis, MI and can be reached out via phone at 269-228-5188.
Location: 1124 Austin, Cassopolis, MI, 49031-9339
Provider Profile Details
NPI Number
1033971577
Provider Name
Shane Liedeke
Credential
Provider Entity Type
Individual
Gender
Male
Address
1124 Austin, Cassopolis, MI, 49031-9339
Phone Number
269-228-5188
Fax Number
Provider Enumeration Date
01/30/2024
Last Update Date
03/10/2024
Provider Business Practice Location Address Details
Address
1124 Austin
City
State
Zip
49031-8310
Phone Number
269-228-5188
Fax Number
Provider Business Mailing Address Details
Address
1124 Austin
City
State
Zip
49031-8310
Phone Number
269-228-5188
Fax Number
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
License No.
()
Definition
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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