Provider Demographics
NPI:1730964222
Name:GUIDRY, SENETRA MARIE (RSW)
Entity type:Individual
Prefix:MRS
First Name:SENETRA
Middle Name:MARIE
Last Name:GUIDRY
Suffix:
Gender:F
Credentials:RSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 FEATHER TAIL CV
Mailing Address - Street 2:
Mailing Address - City:CARENCRO
Mailing Address - State:LA
Mailing Address - Zip Code:70520-5861
Mailing Address - Country:US
Mailing Address - Phone:337-915-8181
Mailing Address - Fax:
Practice Address - Street 1:4315 BLUEBONNET BLVD STE B
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-9661
Practice Address - Country:US
Practice Address - Phone:225-223-6968
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-31
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
LA171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No104100000XBehavioral Health & Social Service ProvidersSocial Worker