Provider Demographics
NPI:1639392293
Name:SHELTON-WILLIAMS, DAWN K (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:K
Last Name:SHELTON-WILLIAMS
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 1:6247 W DONGES LN
Mailing Address - Street 2:
Mailing Address - City:BROWN DEER
Mailing Address - State:WI
Mailing Address - Zip Code:53223-1259
Mailing Address - Country:US
Mailing Address - Phone:414-828-1920
Mailing Address - Fax:
Practice Address - Street 1:6247 W DONGES LN
Practice Address - Street 2:
Practice Address - City:BROWN DEER
Practice Address - State:WI
Practice Address - Zip Code:53223-1259
Practice Address - Country:US
Practice Address - Phone:413-828-1920
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI302-1231041C0700X
104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI39716600Medicaid
WI302123OtherLICENSE