Individual
CINDY L FONSECA-SHIVERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, LCSW
Contact information
Practice address
1794 ALLOUEZ AVE, SUITE C, NUMBER 243, GREEN BAY, WI 54311-6281
(920) 367-4025
Mailing address
1794 ALLOUEZ AVE, SUITE C, NUMBER 243, GREEN BAY, WI 54311-6281
(920) 367-4025
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2359-125
WI
1041C0700X
Clinical Social Worker
4233-123
WI
Other
Enumeration date
08/08/2011
Last updated
02/12/2024
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