Provider Demographics
NPI:1285885145
Name:AMADOR, SHAWN MARIE (LCSW)
Entity type:Individual
Prefix:MS
First Name:SHAWN
Middle Name:MARIE
Last Name:AMADOR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SHAWN
Other - Middle Name:MARIE
Other - Last Name:HEERDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1747 W ROOSEVELT RD DEPT OF
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60608-1264
Mailing Address - Country:US
Mailing Address - Phone:312-996-7723
Mailing Address - Fax:
Practice Address - Street 1:1747 W ROOSEVELT RD DEPT OF
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60608-1264
Practice Address - Country:US
Practice Address - Phone:312-996-7723
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-08
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490113061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical