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

Shane Bastar, SAC-IT

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1457044000

Shane Bastar, SAC-IT is an Addiction (Substance Use Disorder) Counselor in Green Bay, Wisconsin. Practices as a sole proprietor. Licensed in Wisconsin.

Licensed in
WI
In the registry since
2023

Practice location Address checks out

2357 W Mason St
Green Bay, WI 54303-4708
Phone: (920) 337-6740
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence 20212-130 (WI)

Record details

NPI number1457044000
Entity typeIndividual (Type 1)
GenderMale
Credentials SAC-IT
Sole proprietorYes
NPI enumeratedMay 31, 2023
Last updated in NPPESMay 31, 2023
Certification dateMay 31, 2023
Mailing address2357 W Mason St, Green Bay, WI 54303-4708

Other providers in Green Bay