Provider Demographics
NPI:1104954122
Name:WESTBROOKS, SHAWANA (MED)
Entity type:Individual
Prefix:MS
First Name:SHAWANA
Middle Name:
Last Name:WESTBROOKS
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:SHAWANA
Other - Middle Name:
Other - Last Name:NEELY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MED
Mailing Address - Street 1:70 S WALNUT BEND RD
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38018-7295
Mailing Address - Country:US
Mailing Address - Phone:901-643-0918
Mailing Address - Fax:901-369-1433
Practice Address - Street 1:3810 WINCHESTER RD
Practice Address - Street 2:SOUTHEAST MENTAL HEALTH CENTER
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38118-6045
Practice Address - Country:US
Practice Address - Phone:901-369-1400
Practice Address - Fax:901-369-1433
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2007-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker