Provider Demographics
NPI:1952634040
Name:PURRY, SHARI M (LPC)
Entity Type:Individual
Prefix:
First Name:SHARI
Middle Name:M
Last Name:PURRY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1008 MADISON ST
Mailing Address - Street 2:
Mailing Address - City:GRETNA
Mailing Address - State:LA
Mailing Address - Zip Code:70053
Mailing Address - Country:US
Mailing Address - Phone:504-376-9867
Mailing Address - Fax:504-754-7840
Practice Address - Street 1:1008 MADISON ST
Practice Address - Street 2:
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70053-3124
Practice Address - Country:US
Practice Address - Phone:504-376-9867
Practice Address - Fax:504-754-7840
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-08
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5244101Y00000X, 101YP2500X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA3767970Medicaid