Provider Demographics
NPI:1962839639
Name:SHELTON, CORRINE (LPC)
Entity Type:Individual
Prefix:
First Name:CORRINE
Middle Name:
Last Name:SHELTON
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:PO BOX 6744
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70174-6744
Mailing Address - Country:US
Mailing Address - Phone:504-309-7844
Mailing Address - Fax:504-309-7845
Practice Address - Street 1:6641 WESTBANK EXPY
Practice Address - Street 2:STE E
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072-2663
Practice Address - Country:US
Practice Address - Phone:504-236-7752
Practice Address - Fax:504-309-9070
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-26
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3861101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional