Healthcare Provider Details

I. General information

NPI: 1588492003
Provider Name (Legal Business Name): EMAN O SHAHIN LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2024
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 MULBERRY ST
EVANSVILLE IN
47713-1230
US

IV. Provider business mailing address

415 MULBERRY ST
EVANSVILLE IN
47713-1230
US

V. Phone/Fax

Practice location:
  • Phone: 812-423-7791
  • Fax: 812-422-7558
Mailing address:
  • Phone: 812-423-7791
  • Fax: 812-422-7558

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: