Individual
MS. JANICE SHABE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2126 JEFFERSON DAVIS HIGHWAY, SUITE 103, STAFFORD, VA 22554
(540) 658-0888
(540) 658-0855
Mailing address
11225 SALEM VILLAGE DR, FREDERICKSBURG, VA 22407-7663
(540) 373-3223
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810005358
VA
1041C0700X
Clinical Social Worker
0904002993
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004945123
—
VA
01
—
231548
MDIPA
VA
01
—
384750
ANTHEM
VA
Enumeration date
05/03/2006
Last updated
02/12/2020
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