Provider Demographics
NPI:1710127428
Name:MAPLES-EAKES, SHANDRA DAWN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SHANDRA
Middle Name:DAWN
Last Name:MAPLES-EAKES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 HOLLOW CREEK RD
Mailing Address - Street 2:
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-0608
Mailing Address - Country:US
Mailing Address - Phone:817-995-8691
Mailing Address - Fax:
Practice Address - Street 1:1000 HOLLOW CREEK RD
Practice Address - Street 2:
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-0608
Practice Address - Country:US
Practice Address - Phone:817-995-8691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-20
Last Update Date:2009-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX328401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical