Provider Demographics
NPI:1467754465
Name:SHANEY, MONICA RUTH (MSW)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:RUTH
Last Name:SHANEY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 E 45TH ST
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-2114
Mailing Address - Country:US
Mailing Address - Phone:912-596-4717
Mailing Address - Fax:
Practice Address - Street 1:135 E 45TH ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-2114
Practice Address - Country:US
Practice Address - Phone:912-596-4717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-23
Last Update Date:2010-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HILSW-5891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical