Provider Demographics
NPI:1508548348
Name:MONCRIEF, SHENAE MARIYAH (LCSWA)
Entity Type:Individual
Prefix:
First Name:SHENAE
Middle Name:MARIYAH
Last Name:MONCRIEF
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:836 CHARLES CT
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27107-5355
Mailing Address - Country:US
Mailing Address - Phone:336-986-5889
Mailing Address - Fax:
Practice Address - Street 1:500 W NORTHWEST BLVD
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27105-6526
Practice Address - Country:US
Practice Address - Phone:336-748-9028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-02
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP019031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical