Healthcare Provider Details

I. General information

NPI: 1871965491
Provider Name (Legal Business Name): SHARI DAWN ROLLINS RSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/22/2015
Last Update Date: 08/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 WASHINGTON ST STE 401
MONROE LA
71201-6714
US

IV. Provider business mailing address

21 JANA DR
MONROE LA
71203-2737
US

V. Phone/Fax

Practice location:
  • Phone: 318-388-0293
  • Fax:
Mailing address:
  • Phone: 217-390-8521
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number11978
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: