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Individual

CORY SHIVES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCPC

Contact information

Practice address
13121 BROOKLANE DR, HAGERSTOWN, MD 21742-1514
(301) 733-0331
Mailing address
13121 BROOKLANE DR, HAGERSTOWN, MD 21742-1514
(301) 733-0331

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LC8917
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
589057800
MD
Enumeration date
11/29/2016
Last updated
07/19/2022
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