MEDICARE: MS. SHIRA NAAMA GLOGOWER LCSW, LMSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	149017569	IL
2	104100000X	Social Worker	6801108046	MI

General Provider Information

NPI Number	:	1518213495
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SHIRA NAAMA GLOGOWER LCSW, LMSW

Provider Business Mailing Address
First Line	:	1951 GROTON WAY
Second Line	:
City	:	EAST LANSING
State	:	MI
Zip	:	48823-1347
Country	:	US
Telephone Number	:	734-645-1884
Fax Number	:	847-568-5250

Provider Business Practice Location Address
First Line	:	2127 UNIVERSITY PARK DR STE 300O
Second Line	:
City	:	OKEMOS
State	:	MI
Zip	:	48864-5928
Country	:	US
Telephone Number	:	630-382-8805
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/30/2012
Last Update Date	:	09/17/2020

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