Healthcare Provider Details

I. General information

NPI: 1568276434
Provider Name (Legal Business Name): TIARRA MONIQUE ALBERT LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2025
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9420 LINDALE AVE STE ABCD
BATON ROUGE LA
70815-4161
US

IV. Provider business mailing address

1418 TIGER DR
THIBODAUX LA
70301-4337
US

V. Phone/Fax

Practice location:
  • Phone: 225-442-3540
  • Fax:
Mailing address:
  • Phone: 985-449-4055
  • Fax: 985-449-4178

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number16958
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: