Organization
MADELEINE SHAVER, LCSW LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MADELEINE SHAVER LCSW, MAC (OWNER)
(912) 272-5744
Entity
Organization
Contact information
Practice address
700 COMMERCIAL CT STE 102, SAVANNAH, GA 31406-3675
(912) 272-5744
(912) 335-6559
Mailing address
700 COMMERCIAL CT STE 102, SAVANNAH, GA 31406-3675
(912) 335-6559
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
LPC009266
GA
1041C0700X
Clinical Social Worker
Primary
CSW004705
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1477880383
CORESOURSE
GA
Enumeration date
12/28/2017
Last updated
12/28/2017
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