Provider Demographics
NPI:1407977051
Name:HUERSTEL, MAYRA JANET (LCSW)
Entity Type:Individual
Prefix:
First Name:MAYRA
Middle Name:JANET
Last Name:HUERSTEL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MAYRA
Other - Middle Name:J
Other - Last Name:VILLAREAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2900 INDIANA AVE
Mailing Address - Street 2:
Mailing Address - City:KENNER
Mailing Address - State:LA
Mailing Address - Zip Code:70065-4605
Mailing Address - Country:US
Mailing Address - Phone:504-575-3712
Mailing Address - Fax:504-575-3691
Practice Address - Street 1:501 ROBERT BLVD
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458
Practice Address - Country:US
Practice Address - Phone:985-307-1600
Practice Address - Fax:504-575-3691
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA276771041C0700X
LA140711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical