Individual
AUSTIN THOMAS SHIVELY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAPC
Contact information
Practice address
3633 WHEELER RD STE 365, AUGUSTA, GA 30909-6549
(706) 432-6866
(706) 432-8775
Mailing address
3633 WHEELER RD STE 365, AUGUSTA, GA 30909-6549
(706) 432-6866
(706) 432-8775
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YP2500X
Professional Counselor
Primary
APC008650
GA
Other
Enumeration date
07/21/2021
Last updated
09/26/2022
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