Provider Demographics
NPI:1386086338
Name:SHRADER, ADRIENNE RAE (LMHC, CADC)
Entity type:Individual
Prefix:MS
First Name:ADRIENNE
Middle Name:RAE
Last Name:SHRADER
Suffix:
Gender:F
Credentials:LMHC, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1331 BARKLEY CT
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-4221
Mailing Address - Country:US
Mailing Address - Phone:515-520-1606
Mailing Address - Fax:
Practice Address - Street 1:600 5TH STREET
Practice Address - Street 2:SUITE 200
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010
Practice Address - Country:US
Practice Address - Phone:515-232-2051
Practice Address - Fax:515-232-2775
Is Sole Proprietor?:No
Enumeration Date:2013-07-18
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA13065101YA0400X
IA001601101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)