National Provider Identifier

Monroe Demetrius Shim, CASAC

Monroe Demetrius Shim, CASAC is listed in the NPPES registry with a primary specialty of Addiction (Substance Use Disorder) Counselor in Rochester, NY and a listed phone number of (585) 287-5626.

NPI 1336909795Rochester, NYAddiction (Substance Use Disorder) Counselor

Profile Overview

NPI
1336909795
Provider Type
Individual
Primary Specialty
Addiction (Substance Use Disorder) Counselor
Enumeration Date
March 21, 2024
Last Updated
March 21, 2024

Practice Location

  • 1850 Brighton Henrietta Town Line RD
  • Rochester, NY 14623-2532

Phone: (585) 287-5626

Mailing Address

  • 166 Meigs St Apt 4
  • Rochester, NY 14607-2496

Specialties

  • Addiction (Substance Use Disorder) Counselor (101YA0400X)
Full Record
NPI
1336909795
Entity Type
Individual
Last Name
Shim
First Name
Monroe
Middle Name
Demetrius
Name Prefix
Mr.
Credential
CASAC
Mailing Street Address
166 Meigs St Apt 4
Mailing City
Rochester
Mailing State
NY
Mailing ZIP Code
14607-2496
Mailing Country
US
Mailing Phone
(585) 532-3011
Practice Street Address
1850 Brighton Henrietta Town Line RD
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14623-2532
Practice Country
US
Practice Phone
(585) 287-5626
Practice Fax
(585) 287-5628
Enumeration Date
March 21, 2024
Last Updated
March 21, 2024
Sex
Female
Sole Proprietor
No
Certification Date
March 21, 2024
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Addiction (Substance Use Disorder) Counselor (101YA0400X)