Provider Demographics
NPI:1225736895
Name:WOODEN, SHUNDRA JENKINS (LCSW)
Entity Type:Individual
Prefix:
First Name:SHUNDRA
Middle Name:JENKINS
Last Name:WOODEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2804 HARRELL AVE
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23509-2425
Mailing Address - Country:US
Mailing Address - Phone:214-998-8914
Mailing Address - Fax:
Practice Address - Street 1:2804 HARRELL AVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23509-2425
Practice Address - Country:US
Practice Address - Phone:214-998-8914
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-22
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040125661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical