Provider Demographics
NPI:1275021933
Name:HEBERT, TAUSHA K
Entity Type:Individual
Prefix:
First Name:TAUSHA
Middle Name:K
Last Name:HEBERT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TAUSHA
Other - Middle Name:H
Other - Last Name:BATTLEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5635 GLEN OAKS DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70811-6214
Mailing Address - Country:US
Mailing Address - Phone:225-892-5441
Mailing Address - Fax:
Practice Address - Street 1:5635 GLEN OAKS DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70811-6214
Practice Address - Country:US
Practice Address - Phone:225-892-5441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-27
Last Update Date:2019-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA$$$$$$$$$Medicaid