Provider Demographics
NPI:1437607496
Name:LIGGINS, SHAWNDA (MS , NCC, CMHT, LPC)
Entity Type:Individual
Prefix:
First Name:SHAWNDA
Middle Name:
Last Name:LIGGINS
Suffix:
Gender:F
Credentials:MS , NCC, CMHT, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 N MADISON ST
Mailing Address - Street 2:
Mailing Address - City:CORINTH
Mailing Address - State:MS
Mailing Address - Zip Code:38834-5072
Mailing Address - Country:US
Mailing Address - Phone:662-286-9883
Mailing Address - Fax:662-284-9836
Practice Address - Street 1:7139 COMMERCE DR STE C1
Practice Address - Street 2:
Practice Address - City:OLIVE BRANCH
Practice Address - State:MS
Practice Address - Zip Code:38654-2100
Practice Address - Country:US
Practice Address - Phone:662-420-7387
Practice Address - Fax:662-420-7387
Is Sole Proprietor?:No
Enumeration Date:2016-09-19
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS3822101YM0800X
MS2572101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health