Provider Demographics
NPI:1174664916
Name:DUPLESSIS, SHAD M (LCSW)
Entity Type:Individual
Prefix:MR
First Name:SHAD
Middle Name:M
Last Name:DUPLESSIS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8313 PICARDY AVE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-3689
Mailing Address - Country:US
Mailing Address - Phone:225-906-4097
Mailing Address - Fax:225-650-2357
Practice Address - Street 1:8313 PICARDY AVE
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-3689
Practice Address - Country:US
Practice Address - Phone:225-906-4097
Practice Address - Fax:225-650-2357
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA76121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical