Healthcare Provider Details

I. General information

NPI: 1871744722
Provider Name (Legal Business Name): STEPHANIE JO REI LCSW-BACS, C-SSWS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2008
Last Update Date: 02/20/2025
Certification Date: 02/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

539 DOGWOOD SOUTH LN
HAUGHTON LA
71037-8554
US

IV. Provider business mailing address

539 DOGWOOD SOUTH LN
HAUGHTON LA
71037-8554
US

V. Phone/Fax

Practice location:
  • Phone: 318-540-8576
  • Fax:
Mailing address:
  • Phone: 318-540-8576
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number14565
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number280429
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: