Provider Demographics
NPI:1316321938
Name:JOSEPH, SHIRLEY (MS, LPC)
Entity type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 613
Mailing Address - Street 2:
Mailing Address - City:CARENCRO
Mailing Address - State:LA
Mailing Address - Zip Code:70520-0613
Mailing Address - Country:US
Mailing Address - Phone:337-523-6770
Mailing Address - Fax:
Practice Address - Street 1:309 N CHURCH ST
Practice Address - Street 2:
Practice Address - City:CARENCRO
Practice Address - State:LA
Practice Address - Zip Code:70520-3625
Practice Address - Country:US
Practice Address - Phone:337-565-0908
Practice Address - Fax:877-789-4819
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-14
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5529101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional