Provider Demographics
NPI:1962869032
Name:DINGWALL, SHAWNA L (LMSW, CAADC, JSOCCP)
Entity type:Individual
Prefix:MS
First Name:SHAWNA
Middle Name:L
Last Name:DINGWALL
Suffix:
Gender:F
Credentials:LMSW, CAADC, JSOCCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3032 E MOUNT MORRIS RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT MORRIS
Mailing Address - State:MI
Mailing Address - Zip Code:48458-8991
Mailing Address - Country:US
Mailing Address - Phone:810-280-3979
Mailing Address - Fax:
Practice Address - Street 1:3253 CONGRESS AVE
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48602-3106
Practice Address - Country:US
Practice Address - Phone:989-475-4171
Practice Address - Fax:989-393-6021
Is Sole Proprietor?:No
Enumeration Date:2016-01-20
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011138171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical