Healthcare Provider Details

I. General information

NPI: 1164771168
Provider Name (Legal Business Name): RICHARD LOUIS SYLVESTER JR. PHD, MP, MPAP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2012
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 N 7TH ST STE B
WEST MONROE LA
71291-4339
US

IV. Provider business mailing address

1105 HUDSON LN
MONROE LA
71201-6003
US

V. Phone/Fax

Practice location:
  • Phone: 318-503-8300
  • Fax: 318-503-8302
Mailing address:
  • Phone: 318-322-6500
  • Fax: 318-322-5118

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TP0016X
TaxonomyPrescribing (Medical) Psychologist
License Number330644
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code103TP0016X
TaxonomyPrescribing (Medical) Psychologist
License Number349435
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: