Emily Shore, is a
Counselor - Addiction (substance Use Disorder) based in Ravenna, Ohio. Emily Shore is licensed to practice in * (Not Available) (license number ) and her current practice location is
6847 N Chestnut St, Ravenna, Ohio. She can be reached at her office (for appointments etc.) via phone at
(330) 577-5116.
NPI number for Emily Shore is 1164390779 and her current mailing address is 6847 N Chestnut St, Ravenna, Ohio. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1164390779.
Provider's Profile
| Full Name | Emily Shore |
|---|
| Gender | Female |
|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
|---|
| Location | 6847 N Chestnut St, Ravenna, Ohio |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1164390779
- Provider Enumeration Date: 10/27/2025
- Last Update Date: 10/27/2025
Medical Identifiers
Medical identifiers for Emily Shore such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1164390779 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 164W00000X | Licensed Practical Nurse | 138559 (Ohio) | Secondary |
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Emily Shore is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Emily Shore, 6847 N Chestnut St, Ravenna, OH 44266-3929 Ph: () - | Emily Shore, 6847 N Chestnut St, Ravenna, OH 44266-3929 Ph: (330) 577-5116 |
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