Provider Demographics
NPI:1477965044
Name:DAWSON, SHELBI K (LCSW)
Entity Type:Individual
Prefix:
First Name:SHELBI
Middle Name:K
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 1:3300 S MARKET ST STE 118
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758-8127
Mailing Address - Country:US
Mailing Address - Phone:479-366-0850
Mailing Address - Fax:866-308-5285
Practice Address - Street 1:3300 S MARKET ST STE 118
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-8127
Practice Address - Country:US
Practice Address - Phone:479-366-0850
Practice Address - Fax:866-308-5285
Is Sole Proprietor?:No
Enumeration Date:2014-05-29
Last Update Date:2019-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR8009-M104100000X
AR8009-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker