MEDICARE: MYLECKA SHAY JEFFERSON LPC

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	101Y00000X	Counselor	9398	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922473099
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MYLECKA SHAY JEFFERSON LPC

Provider Business Mailing Address
First Line	:	1202 MONROE ST
Second Line	:
City	:	GRETNA
State	:	LA
Zip	:	70053-2307
Country	:	US
Telephone Number	:	504-309-6798
Fax Number	:	504-407-2115

Provider Business Practice Location Address
First Line	:	11616 SOUTHFORK AVE STE 403
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70816-5241
Country	:	US
Telephone Number	:	225-261-7143
Fax Number	:	225-250-1026

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

Provider Enumeration Date	:	12/01/2015
Last Update Date	:	12/10/2025

Similar Medicare Providers

1043174170 — BRIANNA MARIE HUDSON
Practice Location Address:

11616 SOUTHFORK AVE STE 403
BATON ROUGE, LA
70816-5241

Practice Phone: 225-261-7143
Practice Fax:

1225275712 — IBL SPECIAL CARE MANAGEMENT SERVICES
Practice Location Address:

11616 SOUTHFORK AVE , STE 204
BATON ROUGE, LA
70816-5241

Practice Phone: 225-291-3123
Practice Fax: 225-291-3069

1306083894 — IBL SPECIAL CARE MANAGEMENT SERVICES
Practice Location Address:

11616 SOUTHFORK AVE , STE 204
BATON ROUGE, LA
70816-5241

Practice Phone: 225-291-3123
Practice Fax: 225-291-3069

1851538342 — IBL SPECIAL CARE MANAGEMENT SERVICES
Practice Location Address:

11616 SOUTHFORK AVE , STE 204
BATON ROUGE, LA
70816-5241

Practice Phone: 225-291-3123
Practice Fax: 225-291-3069

1922247329 — IBL SPECIAL CARE MANAGEMENT SERVICES
Practice Location Address:

11616 SOUTHFORK AVE STE 204
BATON ROUGE, LA
70816-5241

Practice Phone: 225-291-3123
Practice Fax: 225-291-3069

1164748596 — NOVICE HOUSE OF BATON ROUGE, INC.
Practice Location Address:

11616 SOUTHFORK AVE STE 203
BATON ROUGE, LA
70816-5241

Practice Phone: 225-291-9718
Practice Fax: 225-291-9692

Directions to “ MYLECKA SHAY JEFFERSON LPC” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.