MEDICARE: MRS. NANCY E. SHIVER LMSW

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
1	104100000X	Social Worker	6801082082	MI

General Provider Information

NPI Number	:	1508001595
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. NANCY E. SHIVER LMSW

Provider Business Mailing Address
First Line	:	1600 W PREDMORE RD
Second Line	:
City	:	OAKLAND
State	:	MI
Zip	:	48363-1234
Country	:	US
Telephone Number	:	248-390-5874
Fax Number	:

Provider Business Practice Location Address
First Line	:	1600 W PREDMORE RD
Second Line	:
City	:	OAKLAND
State	:	MI
Zip	:	48363-1234
Country	:	US
Telephone Number	:	248-390-5874
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/05/2008
Last Update Date	:	12/05/2008

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