Provider Demographics
NPI:1093747412
Name:RUDD, SHERRIL (MSW LCSW)
Entity Type:Individual
Prefix:MS
First Name:SHERRIL
Middle Name:
Last Name:RUDD
Suffix:
Gender:F
Credentials:MSW LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 N CAUSEWAY BLVD
Mailing Address - Street 2:ST 1410
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002
Mailing Address - Country:US
Mailing Address - Phone:504-838-9919
Mailing Address - Fax:504-834-3101
Practice Address - Street 1:3500 N CAUSEWAY BLVD
Practice Address - Street 2:ST 1410
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002
Practice Address - Country:US
Practice Address - Phone:504-838-9919
Practice Address - Fax:504-834-3101
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2008-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA19091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
S5376Medicare ID - Type Unspecified