Provider Demographics
NPI:1588215909
Name:HERBERT, SHAKIRA (MSW)
Entity Type:Individual
Prefix:
First Name:SHAKIRA
Middle Name:
Last Name:HERBERT
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2704 YORKTOWNE DR
Mailing Address - Street 2:
Mailing Address - City:LA PLACE
Mailing Address - State:LA
Mailing Address - Zip Code:70068-2104
Mailing Address - Country:US
Mailing Address - Phone:985-634-1690
Mailing Address - Fax:
Practice Address - Street 1:2704 YORKTOWNE DR
Practice Address - Street 2:
Practice Address - City:LA PLACE
Practice Address - State:LA
Practice Address - Zip Code:70068-2104
Practice Address - Country:US
Practice Address - Phone:985-634-1690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-26
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA11059104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker