Provider Demographics
NPI:1538636899
Name:THAGGARD, ASIA BRUMFIELD (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ASIA
Middle Name:BRUMFIELD
Last Name:THAGGARD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3817 JACOB DR
Mailing Address - Street 2:
Mailing Address - City:CHALMETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70043-2747
Mailing Address - Country:US
Mailing Address - Phone:504-915-0100
Mailing Address - Fax:
Practice Address - Street 1:1514 JEFFERSON HWY # 347
Practice Address - Street 2:
Practice Address - City:JEFFERSON
Practice Address - State:LA
Practice Address - Zip Code:70121-2429
Practice Address - Country:US
Practice Address - Phone:504-842-4868
Practice Address - Fax:504-842-2348
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-25
Last Update Date:2018-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA122551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical