Provider Demographics
NPI:1235357740
Name:PAVY, HOLLEY DURANT (LCSW)
Entity Type:Individual
Prefix:
First Name:HOLLEY
Middle Name:DURANT
Last Name:PAVY
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 1:3226 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-3437
Mailing Address - Country:US
Mailing Address - Phone:594-891-0453
Mailing Address - Fax:
Practice Address - Street 1:3226 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-3437
Practice Address - Country:US
Practice Address - Phone:504-891-0453
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical