Provider Demographics
NPI:1205342151
Name:SHAW-WOODY, NINA (LMSW)
Entity type:Individual
Prefix:
First Name:NINA
Middle Name:
Last Name:SHAW-WOODY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8577
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67208-0577
Mailing Address - Country:US
Mailing Address - Phone:316-529-9137
Mailing Address - Fax:316-529-9110
Practice Address - Street 1:333 E ENGLISH ST STE 250
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67202-4315
Practice Address - Country:US
Practice Address - Phone:316-529-9137
Practice Address - Fax:316-529-9110
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-14
Last Update Date:2017-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker