Provider Demographics
NPI:1386438901
Name:MASSEY, SHELINE DE'DREON
Entity type:Individual
Prefix:
First Name:SHELINE
Middle Name:DE'DREON
Last Name:MASSEY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:198 PARKWAY CIR
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71292-8032
Mailing Address - Country:US
Mailing Address - Phone:318-574-0098
Mailing Address - Fax:000-000-0000
Practice Address - Street 1:198 PARKWAY CIR
Practice Address - Street 2:
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71292-8032
Practice Address - Country:US
Practice Address - Phone:318-574-0098
Practice Address - Fax:000-000-0000
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-08
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator