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General NPI Number Information
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NPI Number | 1215849252
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Entity Type | Individual
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Provider Name | ANN MARIE SHAW LMSW
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Gender | Female
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Dates
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Enumeration Date | 09/22/2026
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Last Update Date | 09/22/2026
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Provider Practice Location Address
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Address Line | 6700 BROWNS LAKE RD
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City | JACKSON
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State | MI
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Zip | 49201-8379
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Country | US
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Telephone | 517-768-5200
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Fax |
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Provider Business Mailing Address
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Address Line | 415 MCCLELLAN ST
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City | HUDSON
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State | MI
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Zip | 49247-1131
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Country | US
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Telephone | 517-442-9935
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Fax |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801092200
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number | 6801092200
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License Number State | MI
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