Provider Demographics
NPI:1174712863
Name:DOWLING, SHAWN M (LCDCIII, LISW-S)
Entity type:Individual
Prefix:
First Name:SHAWN
Middle Name:M
Last Name:DOWLING
Suffix:
Gender:F
Credentials:LCDCIII, LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2215 FULLER RD # 116A
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-2303
Mailing Address - Country:US
Mailing Address - Phone:734-845-5058
Mailing Address - Fax:734-845-3462
Practice Address - Street 1:2215 FULLER RD # 116A
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48105-2303
Practice Address - Country:US
Practice Address - Phone:734-845-5058
Practice Address - Fax:734-845-3462
Is Sole Proprietor?:No
Enumeration Date:2007-10-18
Last Update Date:2013-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.0023924-SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical