Healthcare Provider Details

I. General information

NPI: 1710725684
Provider Name (Legal Business Name): SHAMAYA LYNNSHAYE HAGAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHAMAYA LYNNSHAYE YOUNG LMSW

II. Dates (important events)

Enumeration Date: 07/16/2024
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18068 COASTAL HWY STE A
LEWES DE
19958-4901
US

IV. Provider business mailing address

8432 NYLON AVE
SEAFORD DE
19973-5841
US

V. Phone/Fax

Practice location:
  • Phone: 302-268-8720
  • Fax: 833-973-4473
Mailing address:
  • Phone: 302-628-1074
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberQ3-0011415
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberQ1-0012994
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: