Provider Demographics
NPI:1003927484
Name:MANNHEIMER, HENRY M (LCSW)
Entity Type:Individual
Prefix:MR
First Name:HENRY
Middle Name:M
Last Name:MANNHEIMER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10638
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70181-0638
Mailing Address - Country:US
Mailing Address - Phone:504-736-0707
Mailing Address - Fax:504-736-0178
Practice Address - Street 1:1200 S CLEARVIEW PKWY STE 1176
Practice Address - Street 2:
Practice Address - City:HARAHAN
Practice Address - State:LA
Practice Address - Zip Code:70123-2381
Practice Address - Country:US
Practice Address - Phone:504-736-0707
Practice Address - Fax:504-736-0178
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA12561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical