Provider Demographics
NPI:1487227211
Name:GHENT-THORNTON, SHAMIKA S (MSW)
Entity Type:Individual
Prefix:MRS
First Name:SHAMIKA
Middle Name:S
Last Name:GHENT-THORNTON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:SHAMIKA
Other - Middle Name:S
Other - Last Name:GHENT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:146 SW EAGIN HILL LN
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:FL
Mailing Address - Zip Code:32340-4423
Mailing Address - Country:US
Mailing Address - Phone:850-702-8543
Mailing Address - Fax:
Practice Address - Street 1:146 SW EAGIN HILL LN
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:FL
Practice Address - Zip Code:32340-4423
Practice Address - Country:US
Practice Address - Phone:850-702-8543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-20
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical