Provider Demographics
NPI:1003341371
Name:STILLS, A'LYECIA RUTH (LMSW)
Entity type:Individual
Prefix:
First Name:A'LYECIA
Middle Name:RUTH
Last Name:STILLS
Suffix:
Gender:
Credentials:LMSW
Other - Prefix:
Other - First Name:A'LYECIA
Other - Middle Name:RUTH
Other - Last Name:IVORY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8140 BEST DR
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71129-4332
Mailing Address - Country:US
Mailing Address - Phone:318-658-1770
Mailing Address - Fax:
Practice Address - Street 1:2924 KNIGHT ST STE 369
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-2413
Practice Address - Country:US
Practice Address - Phone:318-210-0587
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-25
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X, 171M00000X
LA15067104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No171M00000XOther Service ProvidersCase Manager/Care Coordinator