Healthcare Provider Details

I. General information

NPI: 1447791355
Provider Name (Legal Business Name): SHEMEKA FAULK LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2017
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1405 W PINHOOK RD STE 107
LAFAYETTE LA
70503-3100
US

IV. Provider business mailing address

1405 W PINHOOK RD STE 107
LAFAYETTE LA
70503-3100
US

V. Phone/Fax

Practice location:
  • Phone: 337-232-9457
  • Fax: 337-232-9459
Mailing address:
  • Phone: 337-232-9457
  • Fax: 337-232-9459

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLA8065
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: