Provider Demographics
NPI:1033972070
Name:CAIL, SHANDA WASHINGTON (LMSW)
Entity Type:Individual
Prefix:
First Name:SHANDA
Middle Name:WASHINGTON
Last Name:CAIL
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 1:106 BROOK ORCHARD CIR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71203-8144
Mailing Address - Country:US
Mailing Address - Phone:318-557-3451
Mailing Address - Fax:
Practice Address - Street 1:106 BROOK ORCHARD CIR
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71203-8144
Practice Address - Country:US
Practice Address - Phone:318-557-3451
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-01
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA8550104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker