Provider Demographics
NPI:1437962784
Name:SHIELDS, LAKAYSHA (LMSW)
Entity type:Individual
Prefix:MS
First Name:LAKAYSHA
Middle Name:
Last Name:SHIELDS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8790 MANCHESTER RD STE 205B
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63144-2718
Mailing Address - Country:US
Mailing Address - Phone:314-898-6541
Mailing Address - Fax:
Practice Address - Street 1:8790 MANCHESTER RD STE 205B
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63144-2718
Practice Address - Country:US
Practice Address - Phone:314-898-6541
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-30
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022039055104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty