Provider Demographics
NPI:1568184109
Name:SIRMONS, SHAYLEE (LPC)
Entity Type:Individual
Prefix:
First Name:SHAYLEE
Middle Name:
Last Name:SIRMONS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:717 EAKIN DR
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71107-2503
Mailing Address - Country:US
Mailing Address - Phone:318-751-8843
Mailing Address - Fax:
Practice Address - Street 1:1303 LINE AVE STE 600
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71101-4638
Practice Address - Country:US
Practice Address - Phone:318-425-3400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA8212101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional