Provider Demographics
NPI:1154668804
Name:SCHALESKY, SHERICE T (LCAC)
Entity type:Individual
Prefix:
First Name:SHERICE
Middle Name:T
Last Name:SCHALESKY
Suffix:
Gender:F
Credentials:LCAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 11TH ST W STE 6
Mailing Address - Street 2:
Mailing Address - City:BOTTINEAU
Mailing Address - State:ND
Mailing Address - Zip Code:58318-2005
Mailing Address - Country:US
Mailing Address - Phone:701-228-3326
Mailing Address - Fax:701-228-3327
Practice Address - Street 1:104 11TH ST W STE 6
Practice Address - Street 2:
Practice Address - City:BOTTINEAU
Practice Address - State:ND
Practice Address - Zip Code:58318-2005
Practice Address - Country:US
Practice Address - Phone:701-228-3326
Practice Address - Fax:701-228-3327
Is Sole Proprietor?:No
Enumeration Date:2013-01-14
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1689101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)