Provider Demographics
NPI:1437214376
Name:WARRICK, SHAVON A (LICSW, LCSW-C)
Entity Type:Individual
Prefix:MRS
First Name:SHAVON
Middle Name:A
Last Name:WARRICK
Suffix:
Gender:F
Credentials:LICSW, LCSW-C
Other - Prefix:MRS
Other - First Name:SHAVON
Other - Middle Name:A
Other - Last Name:JEFFERSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LICSW, LCSW-C
Mailing Address - Street 1:10204 EYELET CT
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-5832
Mailing Address - Country:US
Mailing Address - Phone:202-360-2400
Mailing Address - Fax:301-868-7967
Practice Address - Street 1:1012 14TH ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20005-3403
Practice Address - Country:US
Practice Address - Phone:202-737-2554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500779921041C0700X
MD126921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical