Shaw, Gwen
Shaw, Gwen is an sole proprietor health care provider with primary practice located at 3515 22Nd St , Lubbock TX 79410-1307. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Marriage & Family Therapist, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Shaw, Gwen can be contacted via phone (806) 799-8830.Contact Information
Primary practice address
3515 22Nd St
Lubbock TX 79410-1307
Phone: (806) 799-8830
Fax: (806) 799-4688
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Marriage & Family Therapist | 106H00000X | 002503 | Texas |
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 4952 | Texas |
Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 00989 | Texas |
Profile Details
NPI number | 1619902160 |
---|---|
LBN Legal business name | Shaw, Gwen |
Credentials | MSSW LCSW |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Jul 12th, 2006 |
Last updated | May 6th, 2009 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1619902160 | NPPES |
Texas | MEDICAID | 119740203 |
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