MEDICARE: LENIKA STALBERT MHP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator
2	101YP2500X	Professional Counselor	PLC10598	LA

General Provider Information

NPI Number	:	1659827012
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LENIKA STALBERT MHP

Provider Business Mailing Address
First Line	:	317 BROOKTER ST
Second Line	:
City	:	SLIDELL
State	:	LA
Zip	:	70461-3319
Country	:	US
Telephone Number	:	225-459-6966
Fax Number	:

Provider Business Practice Location Address
First Line	:	317 BROOKTER ST
Second Line	:
City	:	SLIDELL
State	:	LA
Zip	:	70461-3319
Country	:	US
Telephone Number	:	985-201-7873
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/26/2016
Last Update Date	:	10/10/2025

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