Provider Demographics
NPI:1831119007
Name:SHIELDS, STEPHEN WILLIAM I (MA LMHC LCAC)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:WILLIAM
Last Name:SHIELDS
Suffix:I
Gender:M
Credentials:MA LMHC LCAC
Other - Prefix:MR
Other - First Name:STEPHEN
Other - Middle Name:WILLIAM
Other - Last Name:SHIELDS
Other - Suffix:I
Other - Last Name Type:Professional Name
Other - Credentials:MA LMHC LCAC
Mailing Address - Street 1:5940 CROOKED CREEK DR
Mailing Address - Street 2:CPC LLC
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46228-1236
Mailing Address - Country:US
Mailing Address - Phone:317-457-2848
Mailing Address - Fax:317-640-2822
Practice Address - Street 1:5940 CROOKED CREEK DR
Practice Address - Street 2:CPC LLC
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46228-1236
Practice Address - Country:US
Practice Address - Phone:317-457-2848
Practice Address - Fax:317-640-2822
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2013-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)