Provider Demographics
NPI:1649529249
Name:PICKETT, SHAWNDRA YVETTE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:SHAWNDRA
Middle Name:YVETTE
Last Name:PICKETT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:SHAWNDRA
Other - Middle Name:DOPLEMORE
Other - Last Name:PICKETT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:12112 SPOKE CIR
Mailing Address - Street 2:
Mailing Address - City:SCHERTZ
Mailing Address - State:TX
Mailing Address - Zip Code:78154-4124
Mailing Address - Country:US
Mailing Address - Phone:832-418-9439
Mailing Address - Fax:
Practice Address - Street 1:3551 ROGER BROOKE DR
Practice Address - Street 2:
Practice Address - City:JBSA FT SAM HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:78234-4504
Practice Address - Country:US
Practice Address - Phone:210-916-5792
Practice Address - Fax:210-916-5102
Is Sole Proprietor?:No
Enumeration Date:2012-08-29
Last Update Date:2018-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX511251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical