Provider Demographics
NPI:1609031673
Name:LIZA M. SHAW
Entity Type:Organization
Organization Name:LIZA M. SHAW
Other - Org Name:MARRIAGE AND FAMILY THERAPY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LIZA
Authorized Official - Middle Name:MERRILL
Authorized Official - Last Name:SHAW
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMFT, ACHT
Authorized Official - Phone:828-328-4673
Mailing Address - Street 1:832 2ND AVE NW
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601
Mailing Address - Country:US
Mailing Address - Phone:828-328-4673
Mailing Address - Fax:828-328-4673
Practice Address - Street 1:832 2ND AVE NW
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601
Practice Address - Country:US
Practice Address - Phone:828-328-4673
Practice Address - Fax:828-328-4673
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-18
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty