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General NPI Number Information
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NPI Number | 1285183483
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Entity Type | Individual
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Provider Name | LAURI SHEDD LCSW
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Gender | Female
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Dates
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Enumeration Date | 09/28/2016
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Last Update Date | 10/31/2023
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Provider Practice Location Address
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Address Line | 1325 S PARK ST # 1003
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City | CARROLLTON
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State | GA
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Zip | 30117-4433
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Country | US
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Telephone | 314-882-0282
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Fax | 470-870-8554
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Provider Business Mailing Address
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Address Line | 1325 S PARK ST # 1003
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City | CARROLLTON
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State | GA
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Zip | 30117-4433
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Country | US
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Telephone | 314-882-0282
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Fax | 470-870-8544
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 2016024037
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License Number State | MO
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