MEDICARE: DR. LASHANDA DENISE BRUMFIELD MPH, CHES, CTRS, PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225800000X	Recreation Therapist	48000	MS
2	174H00000X	Health Educator	11717	MS

General Provider Information

NPI Number	:	1538016845
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LASHANDA DENISE BRUMFIELD MPH, CHES, CTRS, PHD

Provider Business Mailing Address
First Line	:	3872 LOST LAKE CV N
Second Line	:
City	:	JACKSON
State	:	MS
Zip	:	39212-5313
Country	:	US
Telephone Number	:	601-421-8644
Fax Number	:

Provider Business Practice Location Address
First Line	:	3872 LOST LAKE CV N
Second Line	:
City	:	JACKSON
State	:	MS
Zip	:	39212-5313
Country	:	US
Telephone Number	:	601-421-8644
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/16/2026
Last Update Date	:	03/16/2026

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