Provider Demographics
NPI:1285063834
Name:DEWBERRY, SHAWNDA (LMSW)
Entity type:Individual
Prefix:
First Name:SHAWNDA
Middle Name:
Last Name:DEWBERRY
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 1:33207 WESTLAKE DR
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48312-6334
Mailing Address - Country:US
Mailing Address - Phone:586-804-7339
Mailing Address - Fax:586-300-1449
Practice Address - Street 1:13335 15 MILE RD
Practice Address - Street 2:STE 137
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48312-4210
Practice Address - Country:US
Practice Address - Phone:586-804-7833
Practice Address - Fax:586-300-1449
Is Sole Proprietor?:No
Enumeration Date:2013-11-04
Last Update Date:2025-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801095566104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker