Provider Demographics
NPI:1205890860
Name:GARNER, SHAHANA N (LCSW)
Entity type:Individual
Prefix:
First Name:SHAHANA
Middle Name:N
Last Name:GARNER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SHAHANA
Other - Middle Name:
Other - Last Name:KEISLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:9228 GEORGE WASHINGTON MEMORIAL HWY
Mailing Address - Street 2:
Mailing Address - City:GLOUCESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23061-4162
Mailing Address - Country:US
Mailing Address - Phone:804-693-5068
Mailing Address - Fax:804-693-7407
Practice Address - Street 1:9228 GEORGE WASHINGTON MEMORIAL HWY
Practice Address - Street 2:
Practice Address - City:GLOUCESTER
Practice Address - State:VA
Practice Address - Zip Code:23061-4162
Practice Address - Country:US
Practice Address - Phone:804-693-5068
Practice Address - Fax:804-693-7407
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040055791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA386618OtherANTHEM
VA386618OtherHEALTHKEEPERS
VA386618Medicaid
VAO87096MMedicaid
VAO87096MOtherSOUTHERN HEALTH
VA331732OtherTRICARE
VA004945115Medicaid
VA386618OtherHEALTHKEEPERS
VA386618Medicaid