Provider Demographics
NPI:1104642560
Name:SHAW, NATOSHA D (LMSW)
Entity type:Individual
Prefix:
First Name:NATOSHA
Middle Name:D
Last Name:SHAW
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:513 EASTERN AVE
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-2512
Mailing Address - Country:US
Mailing Address - Phone:240-362-4527
Mailing Address - Fax:
Practice Address - Street 1:513 EASTERN AVE
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-2512
Practice Address - Country:US
Practice Address - Phone:240-362-4527
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-02
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD32491104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker