Healthcare Provider Details

I. General information

NPI: 1831539402
Provider Name (Legal Business Name): RUBIE J. W. SCERE LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2013
Last Update Date: 03/20/2020
Certification Date: 03/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

403 JACKSON ST
VIVIAN LA
71082-3503
US

IV. Provider business mailing address

2118 HOLLYWOOD AVE
SHREVEPORT LA
71108-3922
US

V. Phone/Fax

Practice location:
  • Phone: 318-220-6087
  • Fax: 318-632-5099
Mailing address:
  • Phone: 318-220-6087
  • Fax: 318-632-5099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number939
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number939
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number939
License Number StateLA
# 4
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number939
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: