Provider Demographics
NPI:1346250990
Name:MCCHESNEY PERES, KATHLEEN J (LCSW)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:J
Last Name:MCCHESNEY PERES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:J
Other - Last Name:MCCHESNEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:3340 SEVERN AVE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-7407
Mailing Address - Country:US
Mailing Address - Phone:504-889-1448
Mailing Address - Fax:504-889-1452
Practice Address - Street 1:3340 SEVERN AVE
Practice Address - Street 2:SUITE 206
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-7407
Practice Address - Country:US
Practice Address - Phone:504-889-1448
Practice Address - Fax:504-889-1452
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA16381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1666998Medicaid
LAR15151Medicare UPIN
LA338781Medicare PIN
LA1666998Medicaid