Provider Demographics
NPI:1477880383
Name:SHAVER, MADELEINE (LCSW, MAC)
Entity type:Individual
Prefix:
First Name:MADELEINE
Middle Name:
Last Name:SHAVER
Suffix:
Gender:F
Credentials:LCSW, MAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 COMMERCIAL COURT
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406
Mailing Address - Country:US
Mailing Address - Phone:912-272-5744
Mailing Address - Fax:912-335-6559
Practice Address - Street 1:700 COMMERCIAL COURT
Practice Address - Street 2:SUITE 102
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406
Practice Address - Country:US
Practice Address - Phone:912-272-5744
Practice Address - Fax:912-335-6559
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-13
Last Update Date:2014-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0047051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical