SHANE CALHOUN COUNSELING INC (NPI# 1922667302) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922667302 |
| Entity Type | Organization |
| Organization Name | SHANE CALHOUN COUNSELING INC |
| Practice Address |
381 Bayside Rd Ste B Arcata CA 95521-7102 |
| Practice Telephone | 7076161188 |
| Mailing Telephone | 7076161188 |
| Enumeration Date | 2019-06-10 |
| Last Update Date | 2019-06-10 |
| Authorized Official Name | DR. SHANE C CALHOUN (DIRECTOR) |
| Authorized Official Telephone | 7143151685 |
| Authorized Official Credential | PSY.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities | ||
| N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities | ||
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Shane Calhoun Counseling | Doing Business As Name - Organization |
| Street Address |
381 BAYSIDE RD STE B |
| City | ARCATA |
| State | CA |
| Zip Code | 95521-7102 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639674146 | Choong Yuk Kim | Psychologist | 381 Bayside Rd Ste B, Arcata, CA 95521 | 2018-03-27 |
| 1508417734 | Sang Won Kim | Psychologist | 381 Bayside Rd Ste B, Arcata, CA 95521-7102 | 2019-09-29 |
| 1558826842 | Shane Calhoun | Psychologist | 381 Bayside Rd Ste B, Arcata, CA 95521-7102 | 2019-01-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912553736 | Mcc Medical, LLC | Durable Medical Equipment & Medical Supplies | Mcc Medical, LLC, 1565 J Street, Arcata, CA 95521 | 2019-08-16 |
| 1376008599 | Nathan Klier | Behavior Technician | 901 Ost, Arcata, CA 95521 | 2019-02-01 |
| 1740753995 | Maria Sophia Stathos | Behavior Technician | 901 0 Street, Suite C, Arcata, CA 95521 | 2019-01-09 |
| 1194089805 | Gary Wilson Barsuaskas | Nurse Practitioner | 4677 Valley West Blvd., Arcata, CA 95521 | 2012-06-27 |
| 1265708424 | Alison Marie Palacios | Family Medicine | 3798 Janes Rd. Suite 10, Arcata, CA 95521 | 2012-03-31 |
| 1538434857 | Kristen Noell Kelley | Behavioral Analyst | 901 O Street, Suite C, Arcata, CA 95521 | 2012-03-20 |
| 1518241264 | Brian D. Lieberman | Psychologist | 730 Bayside Rd, Apt A, Arcata, CA 95521 | 2011-09-29 |
| 1427369412 | John S Yamas | Acupuncturist | 1460 G. Street, Arcata, CA 95521 | 2010-06-24 |
| 1669619391 | Kevin John Mcalerney | Massage Therapist | 770 11th Street, Lost Coast Healing Arts, Arcata, CA 95521 | 2009-01-16 |
| 1124271499 | Sheridan Michelle Richardson | Acupuncturist | 34 Sunnybrae Center, Arcata, CA 95521 | 2008-10-30 |
| Find all providers in zip 95521 | ||||
| Taxonomy Code | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.