Provider Demographics
NPI:1548783236
Name:FREEMAN, LAUREL BOUDREAUX (LCSW)
Entity Type:Individual
Prefix:
First Name:LAUREL
Middle Name:BOUDREAUX
Last Name:FREEMAN
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 1:4720 NOAH ROAD
Mailing Address - Street 2:
Mailing Address - City:MAURICE
Mailing Address - State:LA
Mailing Address - Zip Code:70555
Mailing Address - Country:US
Mailing Address - Phone:337-349-0004
Mailing Address - Fax:
Practice Address - Street 1:4720 NOAH ROAD
Practice Address - Street 2:
Practice Address - City:MAURICE
Practice Address - State:LA
Practice Address - Zip Code:70555
Practice Address - Country:US
Practice Address - Phone:337-349-0004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA117561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical