Provider Demographics
NPI:1437263746
Name:BURATT, NATHAN S (LCSW)
Entity Type:Individual
Prefix:MR
First Name:NATHAN
Middle Name:S
Last Name:BURATT
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 1:302 DULLES DR
Mailing Address - Street 2:SUITE 1
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-3008
Mailing Address - Country:US
Mailing Address - Phone:337-262-5870
Mailing Address - Fax:337-262-1272
Practice Address - Street 1:302 DULLES DR
Practice Address - Street 2:SUITE 1
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-3008
Practice Address - Country:US
Practice Address - Phone:337-262-5870
Practice Address - Fax:337-262-1272
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA19381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical