Provider Demographics
NPI:1518339597
Name:MONROE, EARNESTINE (LCSW)
Entity Type:Individual
Prefix:
First Name:EARNESTINE
Middle Name:
Last Name:MONROE
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 1:6007 FINANCIAL PLZ STE 207
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71129-2662
Mailing Address - Country:US
Mailing Address - Phone:318-621-0910
Mailing Address - Fax:318-621-0918
Practice Address - Street 1:6007 FINANCIAL PLZ STE 207
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71129-2662
Practice Address - Country:US
Practice Address - Phone:318-621-0910
Practice Address - Fax:318-621-0918
Is Sole Proprietor?:No
Enumeration Date:2015-10-29
Last Update Date:2017-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LALA32041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical