Active NPI
Joanne Shaver, MA, LPCA, LCASA
- Professional Counselor
- Concord, NC
National Provider Identifier
1679911499
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- A-11525
- Practice address
- 284 Executive Park Dr Ste 100
Concord, NC 28025-1833 - Phone
- (704) 939-1100
- Fax
- (704) 939-1173
- NPI assigned
- Jun 14, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 23477-A | NC | |
| Professional Counselor | 101YP2500X | A-11525 | NC | Primary |
Addresses
Primary practice location
284 Executive Park Dr Ste 100
Concord, NC 28025-1833
Mailing address
284 Executive Park Dr
Suite 100
Concord, NC 28025-1894
Phone (704) 939-1100
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679911499 | Medicaid | NC | |
| 19EX3 | Other | NC | BCBS |
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23477-A | NC | MD | Addiction (Substance Use Disorder) Counselor |
| A-11525 | NC | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1371168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1679911499",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "284 EXECUTIVE PARK DR",
"address_2": "SUITE 100",
"city": "CONCORD",
"state": "NC",
"postal_code": "280251894",
"telephone_number": "704-939-1100",
"fax_number": "704-939-1173"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "284 EXECUTIVE PARK DR STE 100",
"city": "CONCORD",
"state": "NC",
"postal_code": "280251833",
"telephone_number": "704-939-1100",
"fax_number": "704-939-1173"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAVER",
"first_name": "JOANNE",
"credential": "MA, LPCA, LCASA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-06-14",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NC",
"license": "23477-A",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "A-11525",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1679911499",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "19EX3",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Concord, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.