Stephanie Shaw, LCSW
Social Worker, Clinical in Los Angeles, CA. Individual provider (NPI-1).
NPI number1164072641
StatusActive
Last updated in NPPESAug 20, 2024
Details
- NPI
- 1164072641
- Entity type
- Individual (NPI-1)
- Name
- Stephanie Shaw
- Credential
- LCSW
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Sep 16, 2019
- Certification date
- Aug 20, 2024
- Last updated
- Aug 20, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 121902 | CA | Yes |
| 225400000X | Rehabilitation Practitioner | – | – | |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Practice location
2121 W Temple StLos Angeles, CA 90026-4915
Phone 818-912-7088
Mailing address
11144 Wystone AveNorthridge, CA 91326-2351
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