person
Ms. Marie Ann Shade, LCPC
Professional Counselor in Boise, Idaho
NPI 1609945831

Marie Ann Shade is a Professional Counselor based in Boise, ID and is specialized in Professional. Marie Ann Shade practices in Boise, ID and has the professional credentials of LCPC. The NPI Number for Marie Ann Shade is 1609945831 and holds a License No. LCPC44 (Idaho).

The current practice location address for Marie Ann Shade is 684 N 9Th Street, Boise, ID and can be reached out via phone at 208-343-6636 and via fax at 208-389-1474.

Location: 684 N 9Th Street, Boise, ID, 85702-5458
person
Provider Profile Details
NPI Number
1609945831
Provider Name
Marie Ann Shade
Credential
LCPC
Provider Entity Type
Individual
Gender
Female
Address
684 N 9Th Street, Boise, ID, 85702-5458
Phone Number
208-343-6636
Fax Number
208-389-1474
Provider Enumeration Date
11/06/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
Q1687 01 ID BLUE CROSS
000010016630 01 ID REGENCE BLUE SHIELD
institution
Provider Business Practice Location Address Details
Address
684 N 9Th Street
City
State
Zip
85702-5458
Phone Number
208-343-6636
Fax Number
208-389-1474
person
Provider Business Mailing Address Details
Address
684 N 9Th Street
City
State
Zip
85702-5458
Phone Number
208-343-6636
Fax Number
208-389-1474
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
LCPC44 (Idaho)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
LCPC44 (Idaho)
Definition
Definition to come...
person
Provider's Taxonomy Details 3
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
LCPC44 (Idaho)
Definition
Definition to come...
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