Provider Demographics
NPI:1326369448
Name:REDDING, SHENITA MICHELL (LPC, LMFT)
Entity Type:Individual
Prefix:MRS
First Name:SHENITA
Middle Name:MICHELL
Last Name:REDDING
Suffix:
Gender:F
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 YOUREE DR STE 320C
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71105-3349
Mailing Address - Country:US
Mailing Address - Phone:318-573-5428
Mailing Address - Fax:318-219-9514
Practice Address - Street 1:4300 YOUREE DR STE 320C
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-3349
Practice Address - Country:US
Practice Address - Phone:318-573-5428
Practice Address - Fax:318-219-9514
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-14
Last Update Date:2010-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2511101YM0800X
LA510101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health