Provider Demographics
NPI:1326866609
Name:SHELTON, SUNDI CROSSWHITE (LMSW)
Entity type:Individual
Prefix:
First Name:SUNDI
Middle Name:CROSSWHITE
Last Name:SHELTON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:SUNDI
Other - Middle Name:
Other - Last Name:CROSSWHITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:6655 SANTA BARBARA RD UNIT 8574
Mailing Address - Street 2:
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-7523
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5461 HILLANDALE DR STE 100
Practice Address - Street 2:
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30058-4842
Practice Address - Country:US
Practice Address - Phone:297-647-0361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-26
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW011740104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker