MEDICARE: SONJA LAWLESS SHANEYFELT LICSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	1404C	AL

General Provider Information

NPI Number	:	1093873796
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SONJA LAWLESS SHANEYFELT LICSW

Provider Business Mailing Address
First Line	:	5009 CEDAR TRACE TRL
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35244-4559
Country	:	US
Telephone Number	:	205-937-0890
Fax Number	:

Provider Business Practice Location Address
First Line	:	5009 CEDAR TRACE TRL
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35244-4559
Country	:	US
Telephone Number	:	205-937-0890
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/05/2006
Last Update Date	:	10/13/2021

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Directions to “ SONJA LAWLESS SHANEYFELT LICSW” Practice Location

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