Provider Demographics
NPI:1467231282
Name:SIMIEN, LEE-ISSAC H (LCSW)
Entity Type:Individual
Prefix:
First Name:LEE-ISSAC
Middle Name:H
Last Name:SIMIEN
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 1:16132 HAYNES BLUFF AVE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70817-2433
Mailing Address - Country:US
Mailing Address - Phone:504-315-5739
Mailing Address - Fax:
Practice Address - Street 1:11408 LAKE SHERWOOD AVE N STE A
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-0421
Practice Address - Country:US
Practice Address - Phone:225-261-7143
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-22
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA148211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical