Provider Demographics
NPI:1093937492
Name:DYER, JOHN LEWIS (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:LEWIS
Last Name:DYER
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 1:3434 CANAL ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-6208
Mailing Address - Country:US
Mailing Address - Phone:504-539-5744
Mailing Address - Fax:504-484-5995
Practice Address - Street 1:3434 CANAL ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-6208
Practice Address - Country:US
Practice Address - Phone:504-539-5744
Practice Address - Fax:504-484-5995
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2011-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA26171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical