Provider Demographics
NPI:1396096954
Name:COXTON, SHAVON D (LMSW - CLINICAL)
Entity type:Individual
Prefix:MRS
First Name:SHAVON
Middle Name:D
Last Name:COXTON
Suffix:
Gender:F
Credentials:LMSW - CLINICAL
Other - Prefix:
Other - First Name:SHAVON
Other - Middle Name:D
Other - Last Name:BARBER, FLOWERS, ZELLNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13426 SCHAEFER HWY
Mailing Address - Street 2:UNIT 27314
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48227-7012
Mailing Address - Country:US
Mailing Address - Phone:313-595-1331
Mailing Address - Fax:
Practice Address - Street 1:13426 SCHAEFER HWY
Practice Address - Street 2:UNIT 27314
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48227-7012
Practice Address - Country:US
Practice Address - Phone:313-595-1331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-24
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.24054501041C0700X
MI68011092271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty