Provider Demographics
NPI:1750047197
Name:STANLEY, SHUNDA DENISE (LMSW)
Entity Type:Individual
Prefix:
First Name:SHUNDA
Middle Name:DENISE
Last Name:STANLEY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:TEXAS TREATMENT SERVICES
Mailing Address - Street 2:207 BROAD STREET
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76301-2219
Mailing Address - Country:US
Mailing Address - Phone:940-500-4903
Mailing Address - Fax:940-500-4906
Practice Address - Street 1:207 BROAD ST
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76301-2219
Practice Address - Country:US
Practice Address - Phone:940-500-4903
Practice Address - Fax:940-500-4906
Is Sole Proprietor?:No
Enumeration Date:2021-11-10
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX39000101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor