Provider Demographics
NPI:1568029072
Name:HARDAWAY, SHAUNDRA BILLS (LPC-MHSP)
Entity Type:Individual
Prefix:MRS
First Name:SHAUNDRA
Middle Name:BILLS
Last Name:HARDAWAY
Suffix:
Gender:F
Credentials:LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1331 UNION AVE STE 1000
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-7501
Mailing Address - Country:US
Mailing Address - Phone:901-308-8517
Mailing Address - Fax:
Practice Address - Street 1:1331 UNION AVE STE 1000
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-7501
Practice Address - Country:US
Practice Address - Phone:901-308-8517
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-21
Last Update Date:2022-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3273101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional