Basic Information
| Provider Information | |||||||||
| NPI: | 1679997068 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | JOSEPH-DUKES | ||||||||
| FirstName: | SHERMONA | ||||||||
| MiddleName: | |||||||||
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| Credential: | MSW, RSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2700 VARNADO ST | ||||||||
| Address2: | |||||||||
| City: | MARRERO | ||||||||
| State: | LA | ||||||||
| PostalCode: | 700726620 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5042632800 | ||||||||
| FaxNumber: | 5042632821 | ||||||||
| Practice Location | |||||||||
| Address1: | 2700 VARNADO ST | ||||||||
| Address2: | |||||||||
| City: | MARRERO | ||||||||
| State: | LA | ||||||||
| PostalCode: | 70072 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5042632800 | ||||||||
| FaxNumber: | 5042632821 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/06/2014 | ||||||||
| LastUpdateDate: | 07/23/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 8883 | LA | Y | Behavioral Health & Social Service Providers | Social Worker |
ID Information
| ID | Type | State | Issuer | Description | 7082416 | 05 | LA | MEDICAID | 104100000X | 05 | LA | MEDICAID |