Provider Demographics
NPI:1245404193
Name:MUGGIVAN, JOHN J (LCSW)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:J
Last Name:MUGGIVAN
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 1:901 VETERANS MEMORIAL BLVD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70005-2837
Mailing Address - Country:US
Mailing Address - Phone:504-273-5877
Mailing Address - Fax:504-305-8510
Practice Address - Street 1:901 VETERANS MEMORIAL BLVD
Practice Address - Street 2:SUITE 207
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70005-2837
Practice Address - Country:US
Practice Address - Phone:504-273-5877
Practice Address - Fax:504-305-8510
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-22
Last Update Date:2009-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA10531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical