Provider Demographics
NPI:1396211280
Name:SEWELL, SHALONDA JEANINE (MS)
Entity Type:Individual
Prefix:MISS
First Name:SHALONDA
Middle Name:JEANINE
Last Name:SEWELL
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MISS
Other - First Name:SHALONDA
Other - Middle Name:JEANINE
Other - Last Name:SEWELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS
Mailing Address - Street 1:273 CEDAR DR
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36617-3951
Mailing Address - Country:US
Mailing Address - Phone:251-583-4641
Mailing Address - Fax:
Practice Address - Street 1:273 CEDAR DR
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36617-3951
Practice Address - Country:US
Practice Address - Phone:251-583-4641
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-17
Last Update Date:2018-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health