Buckley, Shannon Marie

Buckley, Shannon Marie is an sole proprietor health care provider with primary practice located at 45 N Canfield Niles Rd , Austintown OH 44515-2343. She recently has 2 registered licenses in different health care specialties including Nursing Service Related Providers / Home Health Aide, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is her primary health care specialty. Buckley, Shannon Marie can be contacted via phone (330) 270-2380.

Contact Information

Primary practice address
45 N Canfield Niles Rd Austintown OH 44515-2343
Phone: (330) 270-2380
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Related Providers / Home Health Aide 374U00000X 401123830710 Ohio
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X CDCA.163020 Ohio

Profile Details

NPI number 1205241858
LBN Legal business name Buckley, Shannon Marie
Credentials CDCA
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 23rd, 2014
Last updated Jul 21st, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205241858 NPPES
Ohio MEDICAID 0080934

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