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General NPI Number Information
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NPI Number | 1346737244
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Entity Type | Individual
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Provider Name | SHAMEKA T GRANT
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Gender | Female
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Dates
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Enumeration Date | 04/16/2018
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 2080 N HWY 360 STE 220
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City | GRAND PRAIRIE
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State | TX
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Zip | 75050-1451
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Country | US
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Telephone | 214-493-2313
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Fax | 469-520-5283
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Provider Business Mailing Address
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Address Line | 212 BURBERRY
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City | GRAND PRAIRIE
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State | TX
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Zip | 75052-0033
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Country | US
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Telephone | 214-493-2313
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Fax | 469-520-5283
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number | 73857
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 73857
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 73857
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License Number State | TX
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Taxonomy #5
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number | 73857
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License Number State | TX
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Taxonomy #6
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 73857
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License Number State | TX
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