Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Shawna B Park, LISW-S, LCDCIII

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1679822084

Shawna B Park, LISW-S, LCDCIII is a Clinical Social Worker in Columbus, Ohio. Qualified in 2009, 17 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in Ohio.

Years since qualifying
17
Licensed in
OH
In the registry since
2012
Specialties on file
2
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Practice location Address checks out

2327 Gavinley Way
Columbus, OH 43220-7335
Phone: (216) 299-1517
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence I.1101599 (OH)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence 10121 (OH)

Record details

NPI number1679822084
Entity typeIndividual (Type 1)
GenderFemale
Credentials LISW-S , LCDCIII
Sole proprietorYes
NPI enumeratedAugust 30, 2012
Last updated in NPPESJanuary 21, 2015

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2009 (17 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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