Provider Demographics
NPI:1154621761
Name:LASTER, SHALONDA ANDERSON (LCSWA)
Entity type:Individual
Prefix:MRS
First Name:SHALONDA
Middle Name:ANDERSON
Last Name:LASTER
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:MS
Other - First Name:SHALONDA
Other - Middle Name:CHRISTINE
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:205 KENWICK CIRLE
Mailing Address - Street 2:APT A
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27406
Mailing Address - Country:US
Mailing Address - Phone:252-767-3161
Mailing Address - Fax:
Practice Address - Street 1:205 APT. A KENWICK CIRLE
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27406
Practice Address - Country:US
Practice Address - Phone:252-767-3161
Practice Address - Fax:252-767-3161
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-28
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker