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:
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Health care specialties

SpecialtyCodeLicense #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 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619902160 NPPES
Texas MEDICAID 119740203

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