Provider Demographics
NPI:1134671225
Name:HEARD, CAROLYN
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:
Last Name:HEARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:299 BELLE TERRE BLVD
Mailing Address - Street 2:SUITE E
Mailing Address - City:LA PLACE
Mailing Address - State:LA
Mailing Address - Zip Code:70068-2418
Mailing Address - Country:US
Mailing Address - Phone:504-723-7763
Mailing Address - Fax:
Practice Address - Street 1:299 BELLE TERRE BLVD
Practice Address - Street 2:SUITE E
Practice Address - City:LA PLACE
Practice Address - State:LA
Practice Address - Zip Code:70068-2418
Practice Address - Country:US
Practice Address - Phone:504-723-7763
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-25
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral