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General NPI Number Information
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NPI Number | 1427668516
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Entity Type | Individual
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Provider Name | SHAKURA E'SHAUNA WARREN LCSWA
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Gender | Female
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Dates
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Enumeration Date | 08/04/2020
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Last Update Date | 11/06/2024
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Provider Practice Location Address
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Address Line | 175 W FRANKLIN BLVD
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City | GASTONIA
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State | NC
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Zip | 28052-4145
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Country | US
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Telephone | 704-865-3525
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Fax |
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Provider Business Mailing Address
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Address Line | 9821 RESEARCH DR APT 4101
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City | CHARLOTTE
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State | NC
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Zip | 28262-5672
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Country | US
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Telephone | 216-527-3109
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Fax |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | P021457
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | S.2302880-TRNE
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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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 | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State | OH
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