Provider Demographics
NPI:1891046660
Name:FRANCIS, TAHANNA SHRELLE (LMSW)
Entity Type:Individual
Prefix:
First Name:TAHANNA
Middle Name:SHRELLE
Last Name:FRANCIS
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 1:114 HIDDEN OAK DR
Mailing Address - Street 2:
Mailing Address - City:CARENCRO
Mailing Address - State:LA
Mailing Address - Zip Code:70520-5786
Mailing Address - Country:US
Mailing Address - Phone:337-654-6732
Mailing Address - Fax:
Practice Address - Street 1:721 W BUTCHER SWITCH RD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70507-2303
Practice Address - Country:US
Practice Address - Phone:337-521-7960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-20
Last Update Date:2012-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA99561041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool