Provider Demographics
NPI:1215571567
Name:HIRSIUS, BRIAN EDWARD (PLPC)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:EDWARD
Last Name:HIRSIUS
Suffix:
Gender:M
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1459 GRANADA DR
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70122-1919
Mailing Address - Country:US
Mailing Address - Phone:504-812-9054
Mailing Address - Fax:
Practice Address - Street 1:1500 LAFAYETTE ST STE 156
Practice Address - Street 2:
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70053-5778
Practice Address - Country:US
Practice Address - Phone:504-812-9054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-30
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA7323101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty