Provider Demographics
NPI:1619863339
Name:PLEASANT, WILMANEICE SHANTA
Entity type:Individual
Prefix:
First Name:WILMANEICE
Middle Name:SHANTA
Last Name:PLEASANT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1314 JAMES AVE APT 114
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76706-2196
Mailing Address - Country:US
Mailing Address - Phone:254-413-2143
Mailing Address - Fax:
Practice Address - Street 1:1314 JAMES AVE APT 114
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76706-2196
Practice Address - Country:US
Practice Address - Phone:254-413-2143
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-17
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCTB-2025-0392101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health