Healthcare Provider Details

I. General information

NPI: 1932917788
Provider Name (Legal Business Name): SHAUNTYCE DENISE PLOWDEN M.A, PLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/26/2024
Last Update Date: 12/26/2024
Certification Date: 12/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4150 EARHART BLVD
NEW ORLEANS LA
70125-1955
US

IV. Provider business mailing address

9696 HAYNE BLVD APT A12
NEW ORLEANS LA
70127-4744
US

V. Phone/Fax

Practice location:
  • Phone: 504-522-4475
  • Fax:
Mailing address:
  • Phone: 504-338-2623
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPLC10459
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: