Provider Demographics
NPI:1942656921
Name:LOFTON, TYSHICA RHODES (LCSW)
Entity Type:Individual
Prefix:MS
First Name:TYSHICA
Middle Name:RHODES
Last Name:LOFTON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 AUTUMN LAKES RD
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70461-5106
Mailing Address - Country:US
Mailing Address - Phone:504-301-6330
Mailing Address - Fax:
Practice Address - Street 1:1901 MANHATTAN BLVD BLDG D
Practice Address - Street 2:
Practice Address - City:HARVEY
Practice Address - State:LA
Practice Address - Zip Code:70058-3583
Practice Address - Country:US
Practice Address - Phone:504-301-6330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-10
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No251S00000XAgenciesCommunity/Behavioral Health