Individual ProviderShaquwanda HenrySocial WorkerBehavioral Health & Social Service ProvidersPractice Address1010 Auburn Ave, Lafayette, LA 70503-2308(337) 232-9457PECOS EnrollmentBased on the most recent information from CMS, provider Shaquwanda Henry is legally eligible to order and refer claims for DME services only.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1821455130Provider TypeIndividualFull NameHenry, ShaquwandaCredentialLCSWGenderFemaleSole ProprietorNoEnumeration Date1/19/2016Last Updated6/4/2024Contact InformationPractice LocationPractice Address1010 Auburn Ave, Lafayette, LA 70503-2308Phone(337) 232-9457FaxUnlisted FaxMailing LocationMailing Address1010 Auburn Ave, Lafayette, LA 70503-2308Phone(337) 232-9457FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense13076LouisianaCode171M00000XDescriptionCase Manager/Care CoordinatorOther Service ProvidersLicenseUnlisted IssuerCode104100000XDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense13076Louisiana