Provider Demographics
NPI:1407465628
Name:PIERCE, SHELLEY LYNN (BSM, MSP, ACT)
Entity Type:Individual
Prefix:
First Name:SHELLEY
Middle Name:LYNN
Last Name:PIERCE
Suffix:
Gender:F
Credentials:BSM, MSP, ACT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 HAINES AVE
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-0710
Mailing Address - Country:US
Mailing Address - Phone:605-716-7841
Mailing Address - Fax:
Practice Address - Street 1:1520 HAINES AVE
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-0710
Practice Address - Country:US
Practice Address - Phone:605-716-7841
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-23
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)