Provider Demographics
NPI:1023532942
Name:HAWES, SHAWNTAVIA LASHAE (MSW)
Entity type:Individual
Prefix:
First Name:SHAWNTAVIA
Middle Name:LASHAE
Last Name:HAWES
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1492 W FLAGLER ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-2209
Mailing Address - Country:US
Mailing Address - Phone:305-541-5864
Mailing Address - Fax:305-541-8614
Practice Address - Street 1:1492 WEST FLAGLER STREET
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125
Practice Address - Country:US
Practice Address - Phone:305-541-5864
Practice Address - Fax:305-541-8614
Is Sole Proprietor?:No
Enumeration Date:2017-08-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical