Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Shane Michael Anderson, LICDC-CS

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1750513040

Mr. Shane Michael Anderson, LICDC-CS is an Addiction (Substance Use Disorder) Counselor in Waverly, Ohio. Works from 3 locations. Licensed in Ohio.

Licensed in
OH
In the registry since
2009
Specialties on file
4
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Practice location Address checks out

13800 US Highway 23
Waverly, OH 45690-9402
Phone: (740) 947-8777
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 1643 Sr 104, Chillicothe, OH 45601 — (740) 313-4133
  • 601 S Edwin C Moses Blvd, Dayton, OH 45417-3424 — (937) 734-8333

Specialties & licences

Case Manager/Care Coordinator (primary) Taxonomy 171M00000X (OH)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence 081184 (OH)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence 81184-CS (OH)
Peer Specialist Taxonomy 175T00000X

Record details

NPI number1750513040
Entity typeIndividual (Type 1)
GenderMale
Credentials LICDC-CS
Sole proprietorNo
NPI enumeratedAugust 20, 2009
Last updated in NPPESJuly 8, 2025
Certification dateJuly 8, 2025

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