Healthcare Provider Details

I. General information

NPI: 1346518354
Provider Name (Legal Business Name): SHALEECHIA CHANELL SNEED LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/05/2011
Last Update Date: 03/01/2022
Certification Date: 03/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

921 W AVENUE J
LANCASTER CA
93534-3443
US

IV. Provider business mailing address

921 W AVENUE J
LANCASTER CA
93534-3443
US

V. Phone/Fax

Practice location:
  • Phone: 661-949-0131
  • Fax: 661-729-8912
Mailing address:
  • Phone: 661-949-0131
  • Fax: 661-729-8912

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW73337
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: