Provider Demographics
NPI:1467413724
Name:MAYERS, TERRY F (LCSW)
Entity Type:Individual
Prefix:MR
First Name:TERRY
Middle Name:F
Last Name:MAYERS
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 1:1412 THALIA
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70130-4424
Mailing Address - Country:US
Mailing Address - Phone:504-524-5973
Mailing Address - Fax:504-523-3912
Practice Address - Street 1:1412 THALIA ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70130-4424
Practice Address - Country:US
Practice Address - Phone:504-524-5973
Practice Address - Fax:504-523-3912
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA26321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1693341Medicaid
LA5S432Medicare ID - Type Unspecified