Provider Demographics
NPI:1689338139
Name:BEGAY, SHANDIIN LYNELL (MSW)
Entity Type:Individual
Prefix:
First Name:SHANDIIN
Middle Name:LYNELL
Last Name:BEGAY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4326 W MONTROSE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60641-2016
Mailing Address - Country:US
Mailing Address - Phone:505-620-0389
Mailing Address - Fax:
Practice Address - Street 1:4326 W MONTROSE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60641-2016
Practice Address - Country:US
Practice Address - Phone:773-883-9100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-29
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical