Provider Demographics
NPI:1205874161
Name:MCFERRIN, LAURA COLEMAN (LCSW)
Entity type:Individual
Prefix:MS
First Name:LAURA
Middle Name:COLEMAN
Last Name:MCFERRIN
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 1:7330 FERN AVENUE
Mailing Address - Street 2:SUITE 704
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71105-4985
Mailing Address - Country:US
Mailing Address - Phone:318-798-8260
Mailing Address - Fax:318-798-8263
Practice Address - Street 1:7330 FERN AVENUE
Practice Address - Street 2:SUITE 704
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-4985
Practice Address - Country:US
Practice Address - Phone:318-798-8260
Practice Address - Fax:318-798-8263
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-03
Last Update Date:2019-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA38401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA4C070Medicare ID - Type Unspecified