Provider Demographics
NPI:1942415781
Name:GARRETT-FEARS, LASHAUN RANA (MA)
Entity Type:Individual
Prefix:MRS
First Name:LASHAUN
Middle Name:RANA
Last Name:GARRETT-FEARS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:LASHAUN
Other - Middle Name:
Other - Last Name:CLARK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:533 PENDLETON DR
Mailing Address - Street 2:
Mailing Address - City:MONCKS CORNER
Mailing Address - State:SC
Mailing Address - Zip Code:29461-8872
Mailing Address - Country:US
Mailing Address - Phone:971-389-4050
Mailing Address - Fax:971-351-6191
Practice Address - Street 1:533 PENDLETON DR
Practice Address - Street 2:
Practice Address - City:MONCKS CORNER
Practice Address - State:SC
Practice Address - Zip Code:29461-8872
Practice Address - Country:US
Practice Address - Phone:971-389-4050
Practice Address - Fax:971-351-6191
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC7395101YM0800X
IN39001626A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health