Provider Demographics
NPI:1790055697
Name:SHELTON, SARAH K (LPC, NCC)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:K
Last Name:SHELTON
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1799 STUMPF BLVD
Mailing Address - Street 2:BLDG. 5 STE. 3B
Mailing Address - City:TERRYTOWN
Mailing Address - State:LA
Mailing Address - Zip Code:70056-3950
Mailing Address - Country:US
Mailing Address - Phone:504-361-0926
Mailing Address - Fax:504-367-3216
Practice Address - Street 1:1799 STUMPF BLVD
Practice Address - Street 2:BLDG. 5 STE. 3B
Practice Address - City:TERRYTOWN
Practice Address - State:LA
Practice Address - Zip Code:70056-3950
Practice Address - Country:US
Practice Address - Phone:504-361-0926
Practice Address - Fax:504-367-3216
Is Sole Proprietor?:No
Enumeration Date:2012-01-09
Last Update Date:2012-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4393101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional