1679822084

Everything you always wanted to know about PARK B SHAWNA LISW-S, LCDC III but were afraid to ask.

PARK B SHAWNA LISW-S, LCDC III

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Provider Last Name Provider Middle Name Provider First Name Provider Credential
PARK B SHAWNA LISW-S, LCDC III
Gender:
Female
Enumeration date:
2012-08-30
Last update date:
2015-01-21
Current as of:
Is sole proprietor?:
No
Is organization subpart?:
No
In PECOS?:
Yes
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Identifiers

identifier description issuer state

Taxonomies

Taxonomy State License Number Primary?
101Y00000X Counselor OH 10121
104100000X Social Worker OH I.1101599

Phone Numbers

Type Number
Mailing Address Telephone Number 2162991517
Practice Location Address Telephone Number 2162991517

Addresses

Type Address City State Postal Country
Mailing Address 2327 GAVINLEY WAY COLUMBUS OH 43220 OH
Practice Location Address 2327 GAVINLEY WAY COLUMBUS OH 43220 OH

Other NPI Records that share a phone number

NPI Name Address State City
1699164434 SHAWNA PARK LISW-S, LLC
Organization
287 W JOHNSTOWN RD OH COLUMBUS

Other NPI Records that share an address

NPI Name Address State City
1699164434 SHAWNA PARK LISW-S, LLC
Organization
287 W JOHNSTOWN RD OH COLUMBUS