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General NPI Number Information
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NPI Number | 1073162517
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Entity Type | Individual
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Provider Name | MONICA LYNNE SHIVER LCSW
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Gender | Female
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Dates
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Enumeration Date | 09/07/2019
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Last Update Date | 08/15/2023
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Provider Practice Location Address
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Address Line | 1223 AUGUSTA WEST PKWY STE G
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City | AUGUSTA
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State | GA
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Zip | 30909-1807
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Country | US
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Telephone | 803-761-2474
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Fax |
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Provider Business Mailing Address
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Address Line | 1223 AUGUSTA WEST PKWY STE G
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City | AUGUSTA
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State | GA
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Zip | 30909-1807
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Country | US
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Telephone | 803-761-2474
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | CSW008061
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | TPSW2320
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW15669-CP
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License Number State | SC
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CSW008061
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License Number State | GA
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