Individual
ELIZABETH MAGANA SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
13101 ALLEN RD STE 500, SOUTHGATE, MI 48195-2216
(734) 785-7700
(734) 287-1953
Mailing address
1370 RIVERBANK ST, LINCOLN PARK, MI 48146-3834
(313) 268-4454
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
6801087916
MI
104100000X
Social Worker
Primary
6801087916
MI
1041C0700X
Clinical Social Worker
6801087916
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1710286836
—
MI
Enumeration date
01/29/2014
Last updated
10/07/2022
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