Individual
MICHAEL SHOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
200 HIGHWAY 2 W, DEVILS LAKE, ND 58301-3532
(701) 665-2200
(701) 665-2300
Mailing address
PO BOX 650, DEVILS LAKE, ND 58301-0650
(701) 665-2200
(701) 665-2300
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4694
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1456526
—
ND
Enumeration date
03/13/2007
Last updated
10/27/2017
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