Provider Demographics
NPI:1093868978
Name:ROBERT, SHARYN DIANNE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SHARYN
Middle Name:DIANNE
Last Name:ROBERT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 HARDING DR
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70364-2515
Mailing Address - Country:US
Mailing Address - Phone:985-857-3615
Mailing Address - Fax:985-857-3706
Practice Address - Street 1:106 MOSS LN
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360-4080
Practice Address - Country:US
Practice Address - Phone:985-857-3615
Practice Address - Fax:985-857-3706
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA52071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical