Healthcare Provider Details

I. General information

NPI: 1447726187
Provider Name (Legal Business Name): SHELIA L SANDERS LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/20/2018
Last Update Date: 01/13/2025
Certification Date: 01/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1905 W THOMAS ST
HAMMOND LA
70401-2901
US

IV. Provider business mailing address

48314 LABONTE LN
TICKFAW LA
70466-3629
US

V. Phone/Fax

Practice location:
  • Phone: 985-606-3311
  • Fax: 985-605-7231
Mailing address:
  • Phone: 985-662-6672
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPLPC10005
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLMSW11389
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: