Provider Demographics
NPI:1174696520
Name:SMITH, SHERILE (LPC-S)
Entity type:Individual
Prefix:
First Name:SHERILE
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:LPC-S
Other - Prefix:
Other - First Name:SHERILE
Other - Middle Name:SMITH
Other - Last Name:WATTS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1801 MANHATTAN BLVD STE J #303
Mailing Address - Street 2:
Mailing Address - City:HARVEY
Mailing Address - State:LA
Mailing Address - Zip Code:70058
Mailing Address - Country:US
Mailing Address - Phone:985-265-7117
Mailing Address - Fax:
Practice Address - Street 1:1801 MANHATTAN BLVD STE J #303
Practice Address - Street 2:
Practice Address - City:HARVEY
Practice Address - State:LA
Practice Address - Zip Code:70058
Practice Address - Country:US
Practice Address - Phone:985-265-7117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2830101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional