Provider Demographics
NPI:1346509676
Name:WHITE, PATSY MARIE (MSW)
Entity Type:Individual
Prefix:MRS
First Name:PATSY
Middle Name:MARIE
Last Name:WHITE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MRS
Other - First Name:PATSY
Other - Middle Name:MARIE
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW
Mailing Address - Street 1:11720 MORRISON RD
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70128-2033
Mailing Address - Country:US
Mailing Address - Phone:504-669-8967
Mailing Address - Fax:504-301-1262
Practice Address - Street 1:11720 MORRISON RD
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70128-2033
Practice Address - Country:US
Practice Address - Phone:504-669-8967
Practice Address - Fax:504-301-1262
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-07
Last Update Date:2012-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1191103K00000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical