Provider Demographics
NPI:1518213495
Name:GLOGOWER, SHIRA NAAMA (LCSW, LMSW)
Entity Type:Individual
Prefix:MS
First Name:SHIRA
Middle Name:NAAMA
Last Name:GLOGOWER
Suffix:
Gender:F
Credentials:LCSW, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1951 GROTON WAY
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-1347
Mailing Address - Country:US
Mailing Address - Phone:734-645-1884
Mailing Address - Fax:847-568-5250
Practice Address - Street 1:2127 UNIVERSITY PARK DR STE 300O
Practice Address - Street 2:
Practice Address - City:OKEMOS
Practice Address - State:MI
Practice Address - Zip Code:48864-5928
Practice Address - Country:US
Practice Address - Phone:630-382-8805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-30
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490175691041C0700X
MI6801108046104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical