Provider Demographics
NPI:1184365702
Name:SHEPEARD, LAWANDA (LMSW)
Entity type:Individual
Prefix:
First Name:LAWANDA
Middle Name:
Last Name:SHEPEARD
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:PO BOX 431
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:MS
Mailing Address - Zip Code:39051-0431
Mailing Address - Country:US
Mailing Address - Phone:601-720-7759
Mailing Address - Fax:601-298-0951
Practice Address - Street 1:1306 HIGHWAY 35 N
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:MS
Practice Address - Zip Code:39051-3008
Practice Address - Country:US
Practice Address - Phone:601-720-7759
Practice Address - Fax:601-298-0951
Is Sole Proprietor?:No
Enumeration Date:2022-04-06
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSM8018104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker