Provider Demographics
NPI:1326079989
Name:DAWSON, SHIRLEY ANN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SHIRLEY
Middle Name:ANN
Last Name:DAWSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11526 N HIGHWAY 99
Mailing Address - Street 2:
Mailing Address - City:SEMINOLE
Mailing Address - State:OK
Mailing Address - Zip Code:74868-6809
Mailing Address - Country:US
Mailing Address - Phone:405-382-3577
Mailing Address - Fax:
Practice Address - Street 1:126 N BELL AVE
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:OK
Practice Address - Zip Code:74801-6902
Practice Address - Country:US
Practice Address - Phone:405-275-7100
Practice Address - Fax:405-275-7105
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK31651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical