Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mrs. Shannon Bolter, LADC, IADC, PCDGC

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1376177071

Mrs. Shannon Bolter, LADC, IADC, PCDGC is an Undefined Non-Physician Type (Specify) in Omaha, Nebraska. Qualified in 2013, 13 years ago. Licensed in Iowa and Nebraska.

Years since qualifying
13
Licensed in
IA, NE
In the registry since
2020
Specialties on file
3
What do these letters mean?
LADC — Licensed Alcohol and Drug Counselor
A licensed addiction counsellor.

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Practice location Address checks out

108 N 49th St Ste B103
Omaha, NE 68132-3172
Phone: (402) 200-3808
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence 1439 (NE)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence 22R101 (IA)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence 51 (NE)

Record details

NPI number1376177071
Entity typeIndividual (Type 1)
GenderFemale
Credentials LADC , IADC , PCDGC
Sole proprietorNo
NPI enumeratedMarch 3, 2020
Last updated in NPPESNovember 14, 2024
Certification dateNovember 14, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyUNDEFINED NON-PHYSICIAN TYPE (SPECIFY)
Medical schoolOTHER
Graduated 2013 (13 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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