Provider Demographics
NPI:1508189895
Name:DEBORAH R. POITEVENT, LLC
Entity Type:Organization
Organization Name:DEBORAH R. POITEVENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:POITEVENT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-861-1289
Mailing Address - Street 1:PO BOX 6744
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70174-6744
Mailing Address - Country:US
Mailing Address - Phone:504-309-7844
Mailing Address - Fax:504-309-7845
Practice Address - Street 1:7821 MAPLE ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70118-3960
Practice Address - Country:US
Practice Address - Phone:504-861-1289
Practice Address - Fax:504-899-6998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-01
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA42261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty