Provider Demographics
NPI:1225495062
Name:KING, SHERITA (LMSW)
Entity Type:Individual
Prefix:
First Name:SHERITA
Middle Name:
Last Name:KING
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MS
Other - First Name:SHERITA
Other - Middle Name:
Other - Last Name:KING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW
Mailing Address - Street 1:3303 TULANE AVE STE 6&7
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-7139
Mailing Address - Country:US
Mailing Address - Phone:504-826-2675
Mailing Address - Fax:504-826-2686
Practice Address - Street 1:3303 TULANE AVE STE 6&7
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-7139
Practice Address - Country:US
Practice Address - Phone:504-826-2675
Practice Address - Fax:504-826-2686
Is Sole Proprietor?:No
Enumeration Date:2016-01-25
Last Update Date:2016-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA12243104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker