Individual
MYLECKA SHAY JEFFERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
11616 SOUTHFORK AVE STE 403, BATON ROUGE, LA 70816-5241
(225) 261-7143
(225) 250-1026
Mailing address
1202 MONROE ST, GRETNA, LA 70053-2307
(504) 309-6798
(504) 407-2115
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
9398
LA
171M00000X
Case Manager/Care Coordinator
9398
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1922473099
—
LA
Enumeration date
12/01/2015
Last updated
12/15/2025
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