Healthcare Provider Details

I. General information

NPI: 1902619992
Provider Name (Legal Business Name): REBECCA DENISE FAITH SHYRER PLPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2025
Last Update Date: 01/31/2025
Certification Date: 01/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 HOLIDAY BLVD SUITE 400
COVINGTON LA
70433-5282
US

IV. Provider business mailing address

210 W ROBERT ST APT 19
HAMMOND LA
70401-3202
US

V. Phone/Fax

Practice location:
  • Phone: 985-607-6835
  • Fax:
Mailing address:
  • Phone: 757-450-1321
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPLC9683
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: