Provider Demographics
NPI:1649943309
Name:GARNER, SHAWANDA KIMBERLY (LMSW)
Entity type:Individual
Prefix:
First Name:SHAWANDA
Middle Name:KIMBERLY
Last Name:GARNER
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 1:5900 YORK RD STE 108
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21212-3023
Mailing Address - Country:US
Mailing Address - Phone:240-316-1461
Mailing Address - Fax:
Practice Address - Street 1:5900 YORK RD STE 108
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21212-3023
Practice Address - Country:US
Practice Address - Phone:240-316-1461
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-28
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD27454104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker