Provider Demographics
NPI:1063073419
Name:SHAVINGS, LOUISE DIANE (MSW)
Entity type:Individual
Prefix:
First Name:LOUISE
Middle Name:DIANE
Last Name:SHAVINGS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:LOUISE
Other - Middle Name:DIANE
Other - Last Name:SHAVINGS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW
Mailing Address - Street 1:2825 W 42ND AVE
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99517-2830
Mailing Address - Country:US
Mailing Address - Phone:907-243-5130
Mailing Address - Fax:907-248-8350
Practice Address - Street 1:2825 W 42ND AVE
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99517-2830
Practice Address - Country:US
Practice Address - Phone:907-243-5130
Practice Address - Fax:907-248-8350
Is Sole Proprietor?:No
Enumeration Date:2019-06-26
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NAOtherNA