Provider Demographics
NPI:1760732564
Name:KANGETHE, SHALANDA SHEREE (LMFT, EDD)
Entity type:Individual
Prefix:DR
First Name:SHALANDA
Middle Name:SHEREE
Last Name:KANGETHE
Suffix:
Gender:F
Credentials:LMFT, EDD
Other - Prefix:
Other - First Name:SHALANDA
Other - Middle Name:SHEREE
Other - Last Name:CHANEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:EDD
Mailing Address - Street 1:331 CAHABA FOREST CV
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-5511
Mailing Address - Country:US
Mailing Address - Phone:334-200-7890
Mailing Address - Fax:
Practice Address - Street 1:331 CAHABA FOREST CV
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-5511
Practice Address - Country:US
Practice Address - Phone:334-200-7890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-19
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA65398106H00000X
ALA-364106H00000X
AL374K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374K00000XNursing Service Related ProvidersReligious Nonmedical PractitionerGroup - Single Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist