Shane Bastar, SAC-IT
NPI 1457044000ActiveIndividual· Counselor, Addiction (Substance Use Disorder)· Green Bay, WI
Counselor, Addiction (Substance Use Disorder) (SAC-IT) in Green Bay, Wisconsin, licensed in WI, with an NPI issued in May 2023.
Overview
| NPI | 1457044000 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | SAC-IT |
| Sole proprietor | Yes |
| NPI issued | May 31, 2023 |
| Last updated in NPPES | May 31, 2023 |
| Certified by provider | May 31, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Counselor, Addiction (Substance Use Disorder) Primary | 101YA0400X | 20212-130 | WI |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
Other Counselor, Addiction (Substance Use Disorder) providers in Green Bay
- 1801939467
- 1356568299
- 1447466065
- 1740184118
- 1861214348
- 1609124510
- 1255685640
- 1477903524
- 1760745921
- 1386793248
- 1134885361
- 1659020097
All Counselor, Addiction (Substance Use Disorder) providers in Wisconsin →