Provider Demographics
NPI:1225189855
Name:BORDELON, STEVEN K (LCSW)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:K
Last Name:BORDELON
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8017 JEFFERSON HWY
Mailing Address - Street 2:SUITE B-4
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-1681
Mailing Address - Country:US
Mailing Address - Phone:225-932-0052
Mailing Address - Fax:225-932-0053
Practice Address - Street 1:8017 JEFFERSON HWY
Practice Address - Street 2:SUITE B-4
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-1681
Practice Address - Country:US
Practice Address - Phone:225-932-0052
Practice Address - Fax:225-932-0053
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA32381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
72-1427612OtherFEDERAL ID #
LAF3519OtherBLUE CROSS PROVIDER #