Provider Demographics
NPI:1144739400
Name:STRONG, DAVID HERCULES III
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:HERCULES
Last Name:STRONG
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3916 JUNO DR
Mailing Address - Street 2:
Mailing Address - City:CHALMETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70043-1270
Mailing Address - Country:US
Mailing Address - Phone:504-777-0530
Mailing Address - Fax:
Practice Address - Street 1:3916 JUNO DR
Practice Address - Street 2:
Practice Address - City:CHALMETTE
Practice Address - State:LA
Practice Address - Zip Code:70043-1270
Practice Address - Country:US
Practice Address - Phone:504-777-0530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-29
Last Update Date:2017-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health