Provider Demographics
NPI:1477056562
Name:SHEWMAKE, STEVEN BRIAN SR (LMHC, LADAC)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:BRIAN
Last Name:SHEWMAKE
Suffix:SR
Gender:M
Credentials:LMHC, LADAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1531 WHITE PINE DR NE
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87144-0595
Mailing Address - Country:US
Mailing Address - Phone:817-694-8990
Mailing Address - Fax:
Practice Address - Street 1:1531 WHITE PINE DR NE
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87144-0595
Practice Address - Country:US
Practice Address - Phone:817-694-8990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-14
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11500101YA0400X
NMCAD0198431101YA0400X
NMCMH0198921101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)