Provider Demographics
NPI:1881120798
Name:DESAVOIR, SHAKIRA (LMHC, NCC, MA, MS)
Entity type:Individual
Prefix:
First Name:SHAKIRA
Middle Name:
Last Name:DESAVOIR
Suffix:
Gender:F
Credentials:LMHC, NCC, MA, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4220 HICKORY RD APT 2A
Mailing Address - Street 2:
Mailing Address - City:MISHAWAKA
Mailing Address - State:IN
Mailing Address - Zip Code:46545-2531
Mailing Address - Country:US
Mailing Address - Phone:404-580-6969
Mailing Address - Fax:
Practice Address - Street 1:4220 HICKORY RD APT 2A
Practice Address - Street 2:
Practice Address - City:MISHAWAKA
Practice Address - State:IN
Practice Address - Zip Code:46545-2531
Practice Address - Country:US
Practice Address - Phone:404-580-6969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-11
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39004066A101YA0400X
101YM0800X
IN8000673A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)