Provider Demographics
NPI:1700831393
Name:SHAWLSON, DAVID SCOTT (LISW)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:SCOTT
Last Name:SHAWLSON
Suffix:
Gender:M
Credentials:LISW
Other - Prefix:DR
Other - First Name:PAMELA
Other - Middle Name:
Other - Last Name:SHERER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:147 TRUNKO RD
Mailing Address - Street 2:
Mailing Address - City:FAIRLAWN
Mailing Address - State:OH
Mailing Address - Zip Code:44333-3405
Mailing Address - Country:US
Mailing Address - Phone:330-867-8434
Mailing Address - Fax:330-724-1027
Practice Address - Street 1:147 TRUNKO RD
Practice Address - Street 2:
Practice Address - City:FAIRLAWN
Practice Address - State:OH
Practice Address - Zip Code:44333-3405
Practice Address - Country:US
Practice Address - Phone:330-867-8434
Practice Address - Fax:330-724-1027
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI-0051741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical