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Blake Andrew Shupe, AODCOUNSELOR
Addiction (Substance Use Disorder) Counselor in Ukiah, California
NPI 1609359090

Blake Andrew Shupe is an Addiction (Substance Use Disorder) Counselor based in Redwood Valley, CA and is specialized in Addiction (Substance Use Disorder). Blake Andrew Shupe practices in Ukiah, CA and has the professional credentials of AODCOUNSELOR. The NPI Number for Blake Andrew Shupe is 1609359090 and holds a License No. 7581 (California).

The current practice location address for Blake Andrew Shupe is 201 Brush St, Ukiah, CA and can be reached out via phone at 707-462-6290.

Location: 201 Brush St, Ukiah, CA, 95470-9517
person
Provider Profile Details
NPI Number
1609359090
Provider Name
Blake Andrew Shupe
Credential
AODCOUNSELOR
Provider Entity Type
Individual
Gender
Male
Address
201 Brush St, Ukiah, CA, 95470-9517
Phone Number
707-462-6290
Fax Number
Provider Enumeration Date
09/11/2018
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
7581 01 CA CADTP
institution
Provider Business Practice Location Address Details
Address
201 Brush St
City
State
Zip
95482-3424
Phone Number
707-462-6290
Fax Number
person
Provider Business Mailing Address Details
Address
201 Brush St
City
State
Zip
95482-3424
Phone Number
707-462-6290
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
7581 (California)
Definition
Definition to come...
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