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General NPI Number Information
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NPI Number | 1821535634
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Entity Type | Individual
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Provider Name | SHAYEN A. GEORGE M.A.,
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Gender | Male
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Dates
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Enumeration Date | 01/31/2017
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Last Update Date | 01/31/2017
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Provider Practice Location Address
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Address Line | 165 FOREST HILL DR
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City | HUBBARD
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State | OH
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Zip | 44425-2181
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Country | US
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Telephone | 724-813-3193
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Fax | 330-534-7657
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Provider Business Mailing Address
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Address Line | 165 FOREST HILL DR
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City | HUBBARD
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State | OH
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Zip | 44425-2181
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Country | US
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Telephone | 724-813-3193
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Fax | 330-534-7657
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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 | E0001543
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PS002965L
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License Number State | PA
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