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

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1417022468

Shawn Thornton Blakley, MSE, CADCIII is a Mental Health Counselor in Green Bay, Wisconsin. Qualified in 1991, 35 years ago. Accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
35
Licensed in
WI
In the registry since
2006
Specialties on file
2
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Practice location Address checks out

130 E Walnut St Ste 706
Green Bay, WI 54301-4239
Phone: (920) 437-8256
Fax: (920) 437-1188
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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 CADCIII (WI)
Professional Counselor Taxonomy 101YP2500X · Licence 792-125 (WI)

Record details

NPI number1417022468
Entity typeIndividual (Type 1)
GenderMale
Credentials MSE , CADCIII
Sole proprietorNo
NPI enumeratedNovember 22, 2006
Last updated in NPPESSeptember 11, 2025

Medicare enrollment

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

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 1991 (35 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Green Bay