Provider Demographics
NPI:1871529420
Name:CHESTER, SHARON MARIE (LCSW-BACS)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:MARIE
Last Name:CHESTER
Suffix:
Gender:F
Credentials:LCSW-BACS
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:MARIE
Other - Last Name:CARTHEW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1519 E JUDGE PEREZ DR
Mailing Address - Street 2:SUITE 5
Mailing Address - City:CHALMETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70043-5569
Mailing Address - Country:US
Mailing Address - Phone:504-982-7466
Mailing Address - Fax:504-272-0758
Practice Address - Street 1:1519 E JUDGE PEREZ DR
Practice Address - Street 2:SUITE 5
Practice Address - City:CHALMETTE
Practice Address - State:LA
Practice Address - Zip Code:70043-5569
Practice Address - Country:US
Practice Address - Phone:504-982-7466
Practice Address - Fax:504-272-0758
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-24
Last Update Date:2014-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA17481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA3B486OtherMEDICARE PTAN
LA2170066Medicaid