Provider Demographics
NPI:1720300841
Name:SMITH, LASHANDRA JENE (BSW)
Entity type:Individual
Prefix:
First Name:LASHANDRA
Middle Name:JENE
Last Name:SMITH
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:617 E MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:BASTROP
Mailing Address - State:LA
Mailing Address - Zip Code:71220-3833
Mailing Address - Country:US
Mailing Address - Phone:318-239-3890
Mailing Address - Fax:318-281-4196
Practice Address - Street 1:617 E MADISON AVE
Practice Address - Street 2:
Practice Address - City:BASTROP
Practice Address - State:LA
Practice Address - Zip Code:71220-3833
Practice Address - Country:US
Practice Address - Phone:318-239-3890
Practice Address - Fax:318-605-4800
Is Sole Proprietor?:No
Enumeration Date:2010-02-16
Last Update Date:2023-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No104100000XBehavioral Health & Social Service ProvidersSocial Worker