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Individual

LESA K. SHARKEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
718 WEST NEW RIVER ST., GONZALES, LA 70737-2502
(225) 936-9142
(225) 644-9962
Mailing address
718 WEST NEW RIVER ST., GONZALES, LA 70737-2502
(225) 936-9142
(225) 644-9962

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
5898
LA
1041C0700X
Clinical Social Worker
5898
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3B277
MEDICARE PTAN
LA
01
NI6382LS
BLUE CROSS PROVIDER
LA
Enumeration date
06/18/2009
Last updated
02/25/2011
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