Provider Demographics
NPI:1043344344
Name:SHIVER, SHEBA L (PHD)
Entity Type:Individual
Prefix:
First Name:SHEBA
Middle Name:L
Last Name:SHIVER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:871 MOORE TOWN RD
Mailing Address - Street 2:
Mailing Address - City:ROCKY POINT
Mailing Address - State:NC
Mailing Address - Zip Code:28457-7304
Mailing Address - Country:US
Mailing Address - Phone:910-540-3754
Mailing Address - Fax:
Practice Address - Street 1:871 MOORE TOWN RD
Practice Address - Street 2:
Practice Address - City:ROCKY POINT
Practice Address - State:NC
Practice Address - Zip Code:28457-7304
Practice Address - Country:US
Practice Address - Phone:910-540-3754
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY27837103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPSY27837Other1043344344