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General NPI Number Information
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NPI Number | 1003051202
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Entity Type | Individual
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Provider Name | SHADENA PATRICE SHIPMAN MSW
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Gender | Female
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Dates
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Enumeration Date | 12/03/2008
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 73 W MONROE ST STE 422
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City | CHICAGO
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State | IL
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Zip | 60603-4955
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Country | US
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Telephone | 888-500-2067
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Fax |
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Provider Business Mailing Address
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Address Line | 500 HANCOCK ST
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City | SAGINAW
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State | MI
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Zip | 48602-4224
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Country | US
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Telephone | 989-797-3400
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Fax | 989-799-0206
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 150116917
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License Number State | IL
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