Provider Demographics
NPI:1811886369
Name:SHEA, SANDY (LAC)
Entity type:Individual
Prefix:
First Name:SANDY
Middle Name:
Last Name:SHEA
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1314 N LAFITTE RD
Mailing Address - Street 2:
Mailing Address - City:ABBEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70510-3149
Mailing Address - Country:US
Mailing Address - Phone:337-600-1121
Mailing Address - Fax:
Practice Address - Street 1:1314 N LAFITTE RD
Practice Address - Street 2:
Practice Address - City:ABBEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70510-3149
Practice Address - Country:US
Practice Address - Phone:337-600-1121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-30
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LALAC-5179101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)