Provider Demographics
NPI:1578384244
Name:RAPOSA, SHASHAUNA E (LCSW)
Entity type:Individual
Prefix:
First Name:SHASHAUNA
Middle Name:E
Last Name:RAPOSA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 WALNUT CV
Mailing Address - Street 2:
Mailing Address - City:DAWSONVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30534-6992
Mailing Address - Country:US
Mailing Address - Phone:774-294-7885
Mailing Address - Fax:
Practice Address - Street 1:48 WALNUT CV
Practice Address - Street 2:
Practice Address - City:DAWSONVILLE
Practice Address - State:GA
Practice Address - Zip Code:30534-6992
Practice Address - Country:US
Practice Address - Phone:774-294-7885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-24
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0091251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical