Individual
JOANNE SHAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPCA, LCASA
Contact information
Practice address
284 EXECUTIVE PARK DR STE 100, CONCORD, NC 28025-1833
(704) 939-1100
(704) 939-1173
Mailing address
284 EXECUTIVE PARK DR, SUITE 100, CONCORD, NC 28025-1894
(704) 939-1100
(704) 939-1173
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
23477-A
NC
101YP2500X
Professional Counselor
Primary
A-11525
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1679911499
—
NC
01
—
19EX3
BCBS
NC
Enumeration date
06/14/2013
Last updated
07/21/2022
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