Provider Demographics
NPI:1023476884
Name:DAVIS, SHEILA (MED)
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3221 BEHRMAN PL
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70114-8200
Mailing Address - Country:US
Mailing Address - Phone:504-263-2800
Mailing Address - Fax:
Practice Address - Street 1:3221 BEHRMAN PL
Practice Address - Street 2:SUITE 201
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70114
Practice Address - Country:US
Practice Address - Phone:504-263-2800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-08
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA104100000XMedicaid