Provider Demographics
NPI:1851760250
Name:WHALEY, SHALANDRA (MS)
Entity Type:Individual
Prefix:
First Name:SHALANDRA
Middle Name:
Last Name:WHALEY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 HUGHES RD STE 1050
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-3046
Mailing Address - Country:US
Mailing Address - Phone:245-631-7898
Mailing Address - Fax:
Practice Address - Street 1:44 HUGHES RD STE 1050
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-3046
Practice Address - Country:US
Practice Address - Phone:245-631-7898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-16
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL330000025Medicaid