Provider Demographics
NPI:1457067399
Name:HOCK, SHEENA DEON WILLIAMS (LAC, CCS, SAP)
Entity type:Individual
Prefix:
First Name:SHEENA
Middle Name:DEON WILLIAMS
Last Name:HOCK
Suffix:
Gender:F
Credentials:LAC, CCS, SAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17512 GOLDEN EAGLE DR
Mailing Address - Street 2:
Mailing Address - City:PRAIRIEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70769-6036
Mailing Address - Country:US
Mailing Address - Phone:225-931-9108
Mailing Address - Fax:
Practice Address - Street 1:524 S BURNSIDE AVE
Practice Address - Street 2:
Practice Address - City:GONZALES
Practice Address - State:LA
Practice Address - Zip Code:70737-3448
Practice Address - Country:US
Practice Address - Phone:225-257-4677
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-24
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LALAC-5091101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)