Healthcare Provider Details

I. General information

NPI: 1184388662
Provider Name (Legal Business Name): SHAMINA CELESTINE LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2021
Last Update Date: 08/13/2024
Certification Date: 08/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

723 POINT ST
HOUMA LA
70360-4744
US

IV. Provider business mailing address

723 POINT ST
HOUMA LA
70360-4744
US

V. Phone/Fax

Practice location:
  • Phone: 985-851-4488
  • Fax:
Mailing address:
  • Phone: 985-851-4488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberM7530
License Number StateMS
# 2
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: