Healthcare Provider Details

I. General information

NPI: 1033381322
Provider Name (Legal Business Name): SHANIDA ROXANA MAGANA LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2008
Last Update Date: 10/01/2025
Certification Date: 10/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4765 SHERRILLS FORD RD
SALISBURY NC
28147-7543
US

IV. Provider business mailing address

4765 SHERRILLS FORD RD
SALISBURY NC
28147-7543
US

V. Phone/Fax

Practice location:
  • Phone: 972-841-2272
  • Fax:
Mailing address:
  • Phone: 972-841-2272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number57745
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904016778
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLC50078439
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: