Healthcare Provider Details

I. General information

NPI: 1447808761
Provider Name (Legal Business Name): ROCHELLE GIPSON MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ROCHELLE GIPSON

II. Dates (important events)

Enumeration Date: 08/29/2019
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4852 ZACHARY SLAUGHTER HWY STE A
ZACHARY LA
70791-3530
US

IV. Provider business mailing address

16260 AIRLINE HWY STE D
PRAIRIEVILLE LA
70769-4271
US

V. Phone/Fax

Practice location:
  • Phone: 225-654-7000
  • Fax:
Mailing address:
  • Phone: 225-999-2066
  • Fax: 225-372-5152

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number9964
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: