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NPI Code Detail

MEDICARE: MS. REGINE M. CORDON-SHIVER LCSW

MEDICARE: MS. REGINE M. CORDON-SHIVER LCSW
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker0004095FL

General Provider Information

NPI Number : 1518136621
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. REGINE M. CORDON-SHIVER LCSW
Provider Business Mailing Address
First Line : 19425 SW 58TH MNR
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33332-3338
Country : US
Telephone Number : 954-252-3072
Fax Number : 954-252-0738
Provider Business Practice Location Address
First Line : 19425 SW 58TH MNR
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33332-3338
Country : US
Telephone Number : 954-252-3072
Fax Number : 954-252-0738
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/22/2008
Last Update Date : 02/22/2008

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Directions to “ MS. REGINE M. CORDON-SHIVER LCSW” Practice Location

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