Provider Demographics
NPI:1114375474
Name:SAULSBERRY, SHANNON ROCHELLE (LPC)
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:ROCHELLE
Last Name:SAULSBERRY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 S RIVER POINTE
Mailing Address - Street 2:
Mailing Address - City:LA PLACE
Mailing Address - State:LA
Mailing Address - Zip Code:70068-2957
Mailing Address - Country:US
Mailing Address - Phone:504-388-4827
Mailing Address - Fax:
Practice Address - Street 1:75 DOMINICAN RD STE 207
Practice Address - Street 2:
Practice Address - City:LA PLACE
Practice Address - State:LA
Practice Address - Zip Code:70068-3400
Practice Address - Country:US
Practice Address - Phone:985-224-2995
Practice Address - Fax:985-224-2998
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-27
Last Update Date:2016-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4817101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional