Provider Demographics
NPI:1487943858
Name:SHIVER, GALE BATTS (LCAS, CCS, SAP, MAC)
Entity type:Individual
Prefix:MRS
First Name:GALE
Middle Name:BATTS
Last Name:SHIVER
Suffix:
Gender:F
Credentials:LCAS, CCS, SAP, MAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 8211
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27835
Mailing Address - Country:US
Mailing Address - Phone:252-215-3089
Mailing Address - Fax:
Practice Address - Street 1:3219 LANDMARK ST STE 3A
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-7688
Practice Address - Country:US
Practice Address - Phone:252-215-3089
Practice Address - Fax:252-215-3089
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-06
Last Update Date:2019-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
NCLCAS3269101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2544OtherNCSAPPB