MS. SUZANNE VICKERY SHAVER, M.ED., M.A. - NPI NUMBER 1750302642

Summary

Provider Name: MS. SUZANNE VICKERY SHAVER, M.ED., M.A.

NPI Number: 1750302642

Clasification: Counselor (101YM0800X)

Specialization: Mental Health

Address:
81 PARK ST
MANSFIELD, MA
ZIP 02048

Phone Number: (508) 339-9265



Detailed Information

MS. Suzanne Vickery Shaver, M.ED., M.A. is a mental health counselor in Mansfield, MA. The assigned NPI number for this provider is 1750302642 and is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business address is:

81 PARK ST
MANSFIELD, MA
ZIP 02048-233
Phone: (508) 339-9265

The enumeration date for this NPI number is 7/23/2006 and was last updated on 7/8/2007.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 101YM0800X Counselor Mental Health 1327 MA X
2 106H00000X Marriage & Family Therapist 904 MA X

NPI Record

No. Field Name Field Value
1 NPI 1750302642
2 Entity Type Code 1
3 Provider Last Name Legal Name SHAVER
4 Provider First Name SUZANNE
5 Provider Middle Name VICKERY
6 Provider Name Prefix Text MS.
7 Provider Credential Text M.ED., M.A.
8 Provider First Line Business Practice Location Address 81 PARK ST
9 Provider Business Practice Location Address City Name MANSFIELD
10 Provider Business Practice Location Address State Name MA
11 Provider Business Practice Location Address Postal Code 020482233
12 Provider Business Practice Location Address Country Code If outside U S US
13 Provider Business Practice Location Address Telephone Number 5083399265
14 Provider Enumeration Date 7/23/2006
15 Last Update Date 7/8/2007
16 Provider Gender Code F
17 Healthcare Provider Taxonomy Code 1 101YM0800X
18 Provider License Number 1 1327
19 Provider License Number State Code 1 MA
20 Healthcare Provider Primary Taxonomy Switch 1 X
21 Healthcare Provider Taxonomy Code 2 106H00000X
22 Provider License Number 2 904
23 Provider License Number State Code 2 MA
24 Healthcare Provider Primary Taxonomy Switch 2 X
25 Is Sole Proprietor Y

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This page was last updated on: 3/11/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.