Provider Demographics
NPI:1043700537
Name:SHELTON, JESSICA ANN (MSW, CSW)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:ANN
Last Name:SHELTON
Suffix:
Gender:F
Credentials:MSW, CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3060 VALLEY CREEK DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-3169
Mailing Address - Country:US
Mailing Address - Phone:225-923-3733
Mailing Address - Fax:225-923-3735
Practice Address - Street 1:3060 VALLEY CREEK DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-3169
Practice Address - Country:US
Practice Address - Phone:225-923-3733
Practice Address - Fax:225-923-3735
Is Sole Proprietor?:No
Enumeration Date:2018-05-10
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
LA14735104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator