Provider Demographics
NPI:1902146087
Name:SHAMSIE PREJEAN, DANIELLE NICOLE (MA,BCBA, LBA, CATP)
Entity Type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:NICOLE
Last Name:SHAMSIE PREJEAN
Suffix:
Gender:F
Credentials:MA,BCBA, LBA, CATP
Other - Prefix:MRS
Other - First Name:DANIELLE
Other - Middle Name:NICOLE
Other - Last Name:SHAMSIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, BCBA, LBA
Mailing Address - Street 1:7004 SHADOW LN
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70605-9055
Mailing Address - Country:US
Mailing Address - Phone:337-540-0713
Mailing Address - Fax:337-214-2112
Practice Address - Street 1:7004 SHADOW LN
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70605-9055
Practice Address - Country:US
Practice Address - Phone:337-540-0713
Practice Address - Fax:337-214-2112
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-26
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1-13-12827103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst