Active NPI
Joann Anita Shivers, LCPC
- Professional Counselor
- Baltimore, MD
National Provider Identifier
1245534288
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LC3039
- Practice address
- 2113 Koko LN
Baltimore, MD 21216-2925 - Phone
- (410) 746-1184
- NPI assigned
- Jan 5, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LC3039 | MD | Primary |
Addresses
Primary practice location
2113 Koko LN
Baltimore, MD 21216-2925
Mailing address
2113 Koko LN
Baltimore, MD 21216-2925
Phone (410) 746-1184
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LC3039 | MD | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1294185600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1294185600000",
"number": "1245534288",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2113 KOKO LN",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212162925",
"telephone_number": "410-746-1184"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2113 KOKO LN",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212162925",
"telephone_number": "410-746-1184"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIVERS",
"first_name": "JOANN",
"middle_name": "ANITA",
"credential": "LCPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-01-05",
"last_updated": "2011-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MD",
"license": "LC3039",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.