Provider Demographics
NPI:1184670572
Name:FELDER, SHARON ANN (LCSW)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:ANN
Last Name:FELDER
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:PO BOX 51758
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70505-1758
Mailing Address - Country:US
Mailing Address - Phone:337-298-3182
Mailing Address - Fax:800-418-6801
Practice Address - Street 1:201 ESSEN DR
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70507-3605
Practice Address - Country:US
Practice Address - Phone:337-298-3182
Practice Address - Fax:800-418-6801
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-26
Last Update Date:2014-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA9311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5S743Medicare ID - Type Unspecified