Provider Demographics
NPI:1235706821
Name:SMALLWOOD, SHAWN R (LMSW)
Entity Type:Individual
Prefix:
First Name:SHAWN
Middle Name:R
Last Name:SMALLWOOD
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:332 SUMNER HALL DR
Mailing Address - Street 2:
Mailing Address - City:GALLATIN
Mailing Address - State:TN
Mailing Address - Zip Code:37066-3129
Mailing Address - Country:US
Mailing Address - Phone:888-291-4357
Mailing Address - Fax:615-460-4502
Practice Address - Street 1:332 SUMNER HALL DR
Practice Address - Street 2:
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066-3129
Practice Address - Country:US
Practice Address - Phone:888-291-4357
Practice Address - Fax:615-460-4502
Is Sole Proprietor?:No
Enumeration Date:2021-06-10
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000013263104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker