Provider Demographics
NPI:1043598949
Name:DEBBIE URSIN, LCSW, L. L. C.
Entity Type:Organization
Organization Name:DEBBIE URSIN, LCSW, L. L. C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARCELLA
Authorized Official - Middle Name:L
Authorized Official - Last Name:URSIN
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:504-322-2489
Mailing Address - Street 1:2600 METAIRIE CT
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-6312
Mailing Address - Country:US
Mailing Address - Phone:504-322-2489
Mailing Address - Fax:504-322-2489
Practice Address - Street 1:300 CODIFER BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70005-3725
Practice Address - Country:US
Practice Address - Phone:504-322-2489
Practice Address - Fax:504-322-2489
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-26
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA40761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5DW33Medicare PIN