Provider Demographics
NPI:1073657839
Name:MYERS, LAURA MARIE (MSW)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:MARIE
Last Name:MYERS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2901 RIDGELAKE DRIVE
Mailing Address - Street 2:SUITE 116
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-4946
Mailing Address - Country:US
Mailing Address - Phone:504-833-1869
Mailing Address - Fax:504-834-1870
Practice Address - Street 1:2901 RIDGELAKE DRIVE
Practice Address - Street 2:SUITE 116
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-4946
Practice Address - Country:US
Practice Address - Phone:504-833-1869
Practice Address - Fax:504-834-1870
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA11791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
21531OtherBLUE CROSS
21531OtherBLUE CROSS