Provider Demographics
NPI:1164867289
Name:MUGGIVAN, SEAN SEOSOP (LMSW)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:SEOSOP
Last Name:MUGGIVAN
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5001 WESTBANK EXPY
Mailing Address - Street 2:JPHSA - CHILD AND FAMILY SERVICES DIVISION
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072-2954
Mailing Address - Country:US
Mailing Address - Phone:504-349-8798
Mailing Address - Fax:504-349-8768
Practice Address - Street 1:5001 WESTBANK EXPY
Practice Address - Street 2:JPHSA - CHILD AND FAMILY SERVICES DIVISION
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072-2954
Practice Address - Country:US
Practice Address - Phone:504-349-8798
Practice Address - Fax:504-349-8768
Is Sole Proprietor?:No
Enumeration Date:2013-05-02
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA11340104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker