Individual
DAVENA SHABAZZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, CBHCMS
Contact information
Practice address
2860 SAINT AUGUSTINE DR, ORLANDO, FL 32825-7140
(407) 470-3630
(407) 270-5935
Mailing address
2860 SAINT AUGUSTINE DR, ORLANDO, FL 32825-7140
(407) 844-9676
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
ISW12173
FL
171M00000X
Case Manager/Care Coordinator
Primary
CBHCMS.0102557
FL
171M00000X
Case Manager/Care Coordinator
CCM101450-A
FL
Other
Enumeration date
12/21/2017
Last updated
10/16/2022
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