Provider Demographics
NPI:1790022325
Name:MUWWAKKIL, SHERYL BURRELL (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:SHERYL
Middle Name:BURRELL
Last Name:MUWWAKKIL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1436 MARSHALL RICHARDSON RD
Mailing Address - Street 2:
Mailing Address - City:BOGALUSA
Mailing Address - State:LA
Mailing Address - Zip Code:70427-6004
Mailing Address - Country:US
Mailing Address - Phone:985-294-9906
Mailing Address - Fax:
Practice Address - Street 1:402 INDUSTRIAL DR
Practice Address - Street 2:
Practice Address - City:OBERLIN
Practice Address - State:LA
Practice Address - Zip Code:70655-3519
Practice Address - Country:US
Practice Address - Phone:985-294-9906
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-16
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA7070104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker