Provider Demographics
NPI:1407216294
Name:HERRERA THOMAS, SHABRINA TYPIANA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SHABRINA
Middle Name:TYPIANA
Last Name:HERRERA THOMAS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:SHABRINA
Other - Middle Name:F
Other - Last Name:HERRERA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:1820 MAXINE BRANCH WAY
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32218-4764
Mailing Address - Country:US
Mailing Address - Phone:786-352-5222
Mailing Address - Fax:
Practice Address - Street 1:1820 MAXINE BRANCH WAY
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32218-4764
Practice Address - Country:US
Practice Address - Phone:786-352-5222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-07
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW140881041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical