Provider Demographics
NPI:1174346332
Name:ESTEP, SHEYANNE L (RMA, CDCA)
Entity type:Individual
Prefix:
First Name:SHEYANNE
Middle Name:L
Last Name:ESTEP
Suffix:
Gender:F
Credentials:RMA, CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:429 N BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:GREEN SPRINGS
Mailing Address - State:OH
Mailing Address - Zip Code:44836-9653
Mailing Address - Country:US
Mailing Address - Phone:419-904-5638
Mailing Address - Fax:567-686-1412
Practice Address - Street 1:429 N BROADWAY ST
Practice Address - Street 2:
Practice Address - City:GREEN SPRINGS
Practice Address - State:OH
Practice Address - Zip Code:44836-9653
Practice Address - Country:US
Practice Address - Phone:419-904-5638
Practice Address - Fax:567-686-1412
Is Sole Proprietor?:No
Enumeration Date:2024-11-06
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCDCA.190375101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)