L.P.C.

WORK HISTORY

Using the following code, please list in chronological order from oldest to most current your work history from the time you completed

your medical training to the present. It is very important that you use the month and year for each entity listed. Work history is

critical. Failure to provide this information may delay your credentialing .

CODE:

C = Clinical/Group S = Solo Practice A = Academic (Paid Teaching Appointments) H = Civilian Hospital Medical Staff Appointment

M = Military Service (Including Hospital Staff Appointments) O = Other

CODE NAME AND ADDRSS OF ENTITY DATE (From MO/YR to MO/YR)

S Business Impressions, Inc. 02/1992-01/2006

524 Hanley Industrial Dr.

St. Louis, MO 63144

Owner, Michael R. Feldman, 318-***-****

S Louisiana Tech University Graduate School 06/2006-05/2008

Ruston, LA

C Brentwood Psychiatric Hospital 08/07-02/08

1006 Highland Ave. Shreveport, LA 71101

Adult Psychiatric Unit- Mona Quails, LPC, supervisor, 318-***-****

C Pines Treatment Center 03/08- 05/08

6240 Greenwood Rd. Shreveport, LA 71119

Gary L Baker, LCSW, supervisor, 318-***-****

C Caddo Correctional Center 05/08 - 1 2/08

P.O. Box 70110 Shreveport, LA 71137-0110

Cole Flournoy, LPC, Ph.D., supervisor, 318-***-****

C The Providence House 01/09 – 04/10

814 Cotton St., Shreveport, LA 71101

318-***-****

S Private Practice 05/10- 01/11

331 Milam St., Shreveport, LA 71101

C Wood Lake Addiction Recovery Center 01/11 – 04/11

3015 Hwy. 956, Ethel, LA

Dr. Tommy Estis, Director, LPC 225-***-****

C Progressive Health System – Clinical Supervisor 04/11 – 07/11

1208 Greenwell Springs/Port Hudson Rd., Zachary, LA 70791

Sally Siakel, LPC, LMFT, Director 225-***-****

S Turning Point Therapy Clinic 11/11 – 09/12

8752 Quarters Lake Rd., Bldg. #9 Baton Rouge, LA 70809

Private Practice

C Baton Rouge General Hospital – Substance Abuse Counselor 02/12-11/2015

4045 North Blvd. Ste. B

Baton Rouge, LA 70806

Résumé work history for: Michael R. Feldman/318-***-**** 05/26/16

Tyra Dodd, L.C.S.W., Supervisor 225-***-****

S Roads to Wellness, Integrated Therapies ™ 11/01/2011- Present

12097 Old Hammond Hwy. Ste. I-3

Baton Rouge, LA 70816

Private Practice

C West Feliciana Hospital IOP 10/12/2016 - Present

5154 Burnett Road

P.O. Box 368

St. Francisville, LA 70775

LATosha N. Williams, MSN, RN, Director, 225-***-****

* The gap between 08/11 – 11/11 I was attending courses for CEU credits (received 27 hours) and looking for

a new position.

Résumé

Contact this candidate