Provider Demographics
NPI:1093729410
Name:OLIVER, LISA LEBOUEF (LCSW BCD)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:LEBOUEF
Last Name:OLIVER
Suffix:
Gender:F
Credentials:LCSW BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 S COLLEGE
Mailing Address - Street 2:SUITE #144
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503
Mailing Address - Country:US
Mailing Address - Phone:337-233-8052
Mailing Address - Fax:337-237-9891
Practice Address - Street 1:315 S COLLEGE
Practice Address - Street 2:SUITE #144
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503
Practice Address - Country:US
Practice Address - Phone:337-233-8052
Practice Address - Fax:337-237-9891
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA24951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical