Provider Demographics
NPI:1093566903
Name:BURNS, SHAQUAYLA (LMSW)
Entity Type:Individual
Prefix:
First Name:SHAQUAYLA
Middle Name:
Last Name:BURNS
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 1:1941 ASHLEY DR
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76134-8409
Mailing Address - Country:US
Mailing Address - Phone:817-757-0557
Mailing Address - Fax:
Practice Address - Street 1:201 E DEBBIE LN
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-2924
Practice Address - Country:US
Practice Address - Phone:817-797-9868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-28
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker