Provider Demographics
NPI:1831436021
Name:SHEDD, RITA (LCSW)
Entity type:Individual
Prefix:
First Name:RITA
Middle Name:
Last Name:SHEDD
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 1:5105 CITRUS BLVD APT 306
Mailing Address - Street 2:
Mailing Address - City:RIVER RIDGE
Mailing Address - State:LA
Mailing Address - Zip Code:70123-7154
Mailing Address - Country:US
Mailing Address - Phone:484-881-2623
Mailing Address - Fax:
Practice Address - Street 1:5105 CITRUS BLVD APT 306
Practice Address - Street 2:
Practice Address - City:RIVER RIDGE
Practice Address - State:LA
Practice Address - Zip Code:70123-7154
Practice Address - Country:US
Practice Address - Phone:484-881-2623
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-09
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA14711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical