Benjamin Allen Shaw, L.I.S.W.
Social Worker, Clinical in Dubuque, IA. Individual provider (NPI-1).
NPI number1124400510
StatusActive
Last updated in NPPESJan 23, 2025
Details
- NPI
- 1124400510
- Entity type
- Individual (NPI-1)
- Name
- Mr. Benjamin Allen Shaw
- Credential
- L.I.S.W.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 23, 2015
- Certification date
- Jan 23, 2025
- Last updated
- Jan 23, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 007817 | IA | Yes |
Practice location
1690 Elm St Ste 300Dubuque, IA 52001-3679
Phone 563-690-2850 · Fax 563-557-8488
Mailing address
1690 Elm St Ste 300Dubuque, IA 52001-3679
Phone 563-690-2850 · Fax 563-557-8488
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