Healthcare Provider Details

I. General information

NPI: 1821642471
Provider Name (Legal Business Name): SHENETHA RAMSEY PHD, MSW, RSW, CLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2019
Last Update Date: 08/09/2021
Certification Date: 08/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4548 MONARCH AVE
BATON ROUGE LA
70811-5411
US

IV. Provider business mailing address

4548 MONARCH AVE
BATON ROUGE LA
70811-5411
US

V. Phone/Fax

Practice location:
  • Phone: 225-939-0916
  • Fax: 225-357-2423
Mailing address:
  • Phone: 225-939-0916
  • Fax: 225-357-2423

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number8933
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number8933
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: