Healthcare Provider Details

I. General information

NPI: 1144212986
Provider Name (Legal Business Name): ANNE PAGE SHIELDS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 NEWMAN AVE
HARRISONBURG VA
22801-4004
US

IV. Provider business mailing address

110 NEWMAN AVE
HARRISONBURG VA
22801-4004
US

V. Phone/Fax

Practice location:
  • Phone: 540-434-2848
  • Fax: 540-434-2883
Mailing address:
  • Phone: 540-434-2848
  • Fax: 540-434-2883

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number090400174
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: