Provider Demographics
NPI:1174997209
Name:SINGH, SHAINA (LCSW, CCM)
Entity type:Individual
Prefix:
First Name:SHAINA
Middle Name:
Last Name:SINGH
Suffix:
Gender:F
Credentials:LCSW, CCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11736 GAELIC DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78754-5989
Mailing Address - Country:US
Mailing Address - Phone:903-283-0810
Mailing Address - Fax:
Practice Address - Street 1:3823 AIRPORT BLVD
Practice Address - Street 2:STE A-6
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78722-1300
Practice Address - Country:US
Practice Address - Phone:903-283-0810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-01
Last Update Date:2015-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX548761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical