Individual
SHIRLEY OLIVIERI MATHIES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW-BACS, CEAP
Contact information
Practice address
510 E STONER AVE, SHREVEPORT, LA 71101-4243
(318) 990-7073
Mailing address
510 E STONER AVE, SHREVEPORT, LA 71101-4243
(318) 990-7073
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
4067
LA
1041C0700X
Clinical Social Worker
Primary
4067
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05
—
LA
Enumeration date
09/06/2019
Last updated
05/01/2024
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