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General NPI Number Information
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NPI Number | 1184254476
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Entity Type | Individual
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Provider Name | SHAIRA A. SHAH LCSW, JD, LPN, C.HT.
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Gender | Female
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Dates
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Enumeration Date | 01/25/2020
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 175 N BINKLEY ST UNIT 581
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City | SOLDOTNA
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State | AK
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Zip | 99669-0269
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Country | US
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Telephone | 954-483-5576
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Fax |
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Provider Business Mailing Address
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Address Line | 7730 GRANADA BLVD
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City | MIRAMAR
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State | FL
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Zip | 33023-5801
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Country | US
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Telephone | 954-483-5576
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 215230
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License Number State | AK
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