Provider Demographics
NPI:1922389659
Name:SHAVER, KAREN L (LMFT)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:L
Last Name:SHAVER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10426 N 11TH ST
Mailing Address - Street 2:UNIT 3
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-8537
Mailing Address - Country:US
Mailing Address - Phone:602-920-6578
Mailing Address - Fax:
Practice Address - Street 1:4600 E SHEA BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85028-6058
Practice Address - Country:US
Practice Address - Phone:480-464-7466
Practice Address - Fax:480-969-2696
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-08
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLMFT-10268106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist