Provider Demographics
NPI:1669291860
Name:SHALER, BRANDI (LMSW, MS, CPC)
Entity type:Individual
Prefix:
First Name:BRANDI
Middle Name:
Last Name:SHALER
Suffix:
Gender:F
Credentials:LMSW, MS, CPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8374 TIMBER CABIN
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78250-4249
Mailing Address - Country:US
Mailing Address - Phone:570-295-5803
Mailing Address - Fax:
Practice Address - Street 1:8374 TIMBER CABIN
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78250-4249
Practice Address - Country:US
Practice Address - Phone:570-295-5803
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-07
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX105332104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker