Healthcare Provider Details

I. General information

NPI: 1639466253
Provider Name (Legal Business Name): SHANEEKA S HARRISON LAC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2011
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 POINTMERE DR
HARVEY LA
70058-2152
US

IV. Provider business mailing address

2401 POINTMERE DR
HARVEY LA
70058-2152
US

V. Phone/Fax

Practice location:
  • Phone: 504-650-2297
  • Fax:
Mailing address:
  • Phone: 504-650-2297
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number1257
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: