Provider Demographics
NPI:1770466542
Name:LUERS, SHANE L
Entity type:Individual
Prefix:
First Name:SHANE
Middle Name:L
Last Name:LUERS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1127 ROBIN HILL CT
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21015-5771
Mailing Address - Country:US
Mailing Address - Phone:443-991-6445
Mailing Address - Fax:
Practice Address - Street 1:1308 BUSINESS CENTER WAY STE 102
Practice Address - Street 2:
Practice Address - City:EDGEWOOD
Practice Address - State:MD
Practice Address - Zip Code:21040-1504
Practice Address - Country:US
Practice Address - Phone:443-461-3311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-29
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)