Provider Demographics
NPI:1225051949
Name:MCINTIRE, MICHELE YVONNE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MICHELE
Middle Name:YVONNE
Last Name:MCINTIRE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5611 CARLISLE CT
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70131-7207
Mailing Address - Country:US
Mailing Address - Phone:504-232-6368
Mailing Address - Fax:
Practice Address - Street 1:5611 CARLISLE CT
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70131-7207
Practice Address - Country:US
Practice Address - Phone:504-232-6368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2011-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA20531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical