Provider Demographics
NPI:1851082788
Name:WHEAT, SHAWNA (LMSW)
Entity Type:Individual
Prefix:
First Name:SHAWNA
Middle Name:
Last Name:WHEAT
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 1:225 CHARLESTON DR
Mailing Address - Street 2:
Mailing Address - City:ANNA
Mailing Address - State:TX
Mailing Address - Zip Code:75409-5250
Mailing Address - Country:US
Mailing Address - Phone:575-937-2257
Mailing Address - Fax:
Practice Address - Street 1:225 CHARLESTON DR
Practice Address - Street 2:
Practice Address - City:ANNA
Practice Address - State:TX
Practice Address - Zip Code:75409-5250
Practice Address - Country:US
Practice Address - Phone:157-593-7225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-19
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker