Provider Demographics
NPI:1316429970
Name:MATTHEWS, LAMONICA DESHAWN (BSW, MA)
Entity type:Individual
Prefix:MISS
First Name:LAMONICA
Middle Name:DESHAWN
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:BSW, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58155 CHINN ST
Mailing Address - Street 2:
Mailing Address - City:PLAQUEMINE
Mailing Address - State:LA
Mailing Address - Zip Code:70764-3601
Mailing Address - Country:US
Mailing Address - Phone:225-385-4543
Mailing Address - Fax:
Practice Address - Street 1:58155 CHINN ST
Practice Address - Street 2:
Practice Address - City:PLAQUEMINE
Practice Address - State:LA
Practice Address - Zip Code:70764-3601
Practice Address - Country:US
Practice Address - Phone:225-385-4543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-30
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health