Paris C Shields Llc | |
3354 Greystone Way Valdosta GA 31605-1096 | |
(229) 241-7883 | |
(229) 241-7479 |
Full Name | Paris C Shields Llc |
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Speciality | Social Worker |
Location | 3354 Greystone Way, Valdosta, Georgia |
Authorized Official Name and Position | Paris C Shields (OWNER) |
Authorized Official Contact | 2292417883 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Paris C Shields Llc 3354 Greystone Way Valdosta GA 31605-1096 Ph: (229) 241-7883 | Paris C Shields Llc 3354 Greystone Way Valdosta GA 31605-1096 Ph: (229) 241-7883 |
NPI Number | 1417300690 |
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Provider Enumeration Date | 07/22/2016 |
Last Update Date | 07/22/2016 |
Medicare PECOS PAC ID | 7012202278 |
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Medicare Enrollment ID | O20160826000937 |
Identifier | Type | State | Issuer |
---|---|---|---|
1417300690 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | CSW005676 (Georgia) | Primary |
Provider Name | Paris Shields |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1114270436 PECOS PAC ID: 9537458518 Enrollment ID: I20160513001428 |
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