MEDICARE: PAMELA DENISE SHAKIR LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	1041C0700X	Clinical Social Worker
2	1041C0700X	Clinical Social Worker	CA
3	1041C0700X	Clinical Social Worker	GA

General Provider Information

NPI Number	:	1245571652
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAMELA DENISE SHAKIR LCSW

Provider Business Mailing Address
First Line	:	1701 WESTWIND DR STE 110
Second Line	:
City	:	BAKERSFIELD
State	:	CA
Zip	:	93301-3045
Country	:	US
Telephone Number	:	661-472-7097
Fax Number	:	844-689-0922

Provider Business Practice Location Address
First Line	:	3343 PEACHTREE RD NE STE 145-573
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30326-1085
Country	:	US
Telephone Number	:	661-472-7097
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/11/2013
Last Update Date	:	11/30/2021

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