Provider Demographics
NPI:1649566449
Name:SHIVAR, JANIE (LCSW)
Entity Type:Individual
Prefix:
First Name:JANIE
Middle Name:
Last Name:SHIVAR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5524 FOREST OAKS DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-5066
Mailing Address - Country:US
Mailing Address - Phone:919-673-7392
Mailing Address - Fax:
Practice Address - Street 1:5524 FOREST OAKS DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-5066
Practice Address - Country:US
Practice Address - Phone:919-673-7392
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-21
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0025851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical