Provider Demographics
NPI:1497460216
Name:STANSBURY, MARIE DENISE FUSELIER (LMSW)
Entity Type:Individual
Prefix:
First Name:MARIE DENISE
Middle Name:FUSELIER
Last Name:STANSBURY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:F
Other - Last Name:STANSBURY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW
Mailing Address - Street 1:405 E BAYOU PKWY
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-4109
Mailing Address - Country:US
Mailing Address - Phone:337-654-4398
Mailing Address - Fax:
Practice Address - Street 1:405 E BAYOU PKWY
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-4109
Practice Address - Country:US
Practice Address - Phone:337-654-4398
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-16
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA17019104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker