Provider Demographics
NPI:1154087112
Name:WARE, SHAWN L (LLBSW)
Entity Type:Individual
Prefix:
First Name:SHAWN
Middle Name:L
Last Name:WARE
Suffix:
Gender:F
Credentials:LLBSW
Other - Prefix:
Other - First Name:SHAWN
Other - Middle Name:
Other - Last Name:WASHINGTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9773 SOUTH M-37
Mailing Address - Street 2:
Mailing Address - City:BALDWIN
Mailing Address - State:MI
Mailing Address - Zip Code:49304-0422
Mailing Address - Country:US
Mailing Address - Phone:231-250-0075
Mailing Address - Fax:
Practice Address - Street 1:1049 E NEWELL ST
Practice Address - Street 2:
Practice Address - City:WHITE CLOUD
Practice Address - State:MI
Practice Address - Zip Code:49349-8795
Practice Address - Country:US
Practice Address - Phone:231-689-7330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-15
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker