Healthcare Provider Details

I. General information

NPI: 1902431489
Provider Name (Legal Business Name): SHELRIKA S BRYANT PLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2020
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 N 16TH ST
MER ROUGE LA
71261-9726
US

IV. Provider business mailing address

PO BOX 792
BASTROP LA
71221-0792
US

V. Phone/Fax

Practice location:
  • Phone: 318-239-8010
  • Fax:
Mailing address:
  • Phone: 318-239-8010
  • Fax: 318-647-3909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberPLC9314
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPLC9314
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: