Provider Demographics
NPI:1548573835
Name:ALLEN-SHERROD, SHALUNDA DENISE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SHALUNDA
Middle Name:DENISE
Last Name:ALLEN-SHERROD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:SHALUNDA
Other - Middle Name:DENISE
Other - Last Name:ALLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5642 WALL TRIANA HWY
Mailing Address - Street 2:SUITE A
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-9756
Mailing Address - Country:US
Mailing Address - Phone:256-759-3279
Mailing Address - Fax:256-325-9001
Practice Address - Street 1:2002 POOLE DR NW
Practice Address - Street 2:SUITE D
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35810-3887
Practice Address - Country:US
Practice Address - Phone:256-715-1050
Practice Address - Fax:256-325-9001
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-15
Last Update Date:2010-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2301C104100000X, 1041C0700X, 1041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool