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NPI Code Detail

MEDICARE: AMY LYNN SHIVES LCSW-C

MEDICARE: AMY LYNN SHIVES LCSW-C
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
11041C0700XClinical Social Worker17883MD
21041C0700XClinical Social WorkerQ1-0001386DE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1992257687
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY LYNN SHIVES LCSW-C
Provider Business Mailing Address
First Line : 185 ADMIRAL COCHRANE DR STE 120
Second Line :
City : ANNAPOLIS
State : MD
Zip : 21401-7600
Country : US
Telephone Number : 443-440-5788
Fax Number :
Provider Business Practice Location Address
First Line : 111 E MAIN ST STE B
Second Line :
City : ELKTON
State : MD
Zip : 21921-5996
Country : US
Telephone Number : 434-406-3234
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/27/2016
Last Update Date : 05/26/2026

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