Provider Demographics
NPI:1356986376
Name:MALONEY, SHATERRICA DENAE (LPC)
Entity type:Individual
Prefix:MRS
First Name:SHATERRICA
Middle Name:DENAE
Last Name:MALONEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:SHATERRICA
Other - Middle Name:DENAR
Other - Last Name:SAMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:206 E REYNOLDS DR STE F2
Mailing Address - Street 2:
Mailing Address - City:RUSTON
Mailing Address - State:LA
Mailing Address - Zip Code:71270-2809
Mailing Address - Country:US
Mailing Address - Phone:318-224-7223
Mailing Address - Fax:
Practice Address - Street 1:206 E REYNOLDS DR STE F2
Practice Address - Street 2:
Practice Address - City:RUSTON
Practice Address - State:LA
Practice Address - Zip Code:71270-2809
Practice Address - Country:US
Practice Address - Phone:318-224-7223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-13
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA7173101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional