Provider Demographics
NPI:1083394175
Name:HARDAWAY, SHANIQUA (LMSW)
Entity Type:Individual
Prefix:
First Name:SHANIQUA
Middle Name:
Last Name:HARDAWAY
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 1:3219 VILLAGE POND LN
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:TX
Mailing Address - Zip Code:77545-8781
Mailing Address - Country:US
Mailing Address - Phone:281-763-8281
Mailing Address - Fax:
Practice Address - Street 1:2440 TEXAS PKWY STE 340A
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77489-4073
Practice Address - Country:US
Practice Address - Phone:832-598-4003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1072331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical