Provider Demographics
NPI:1558324749
Name:CHABAUD, SUZANNE A (PHD)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:A
Last Name:CHABAUD
Suffix:
Gender:F
Credentials:PHD
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3520 GENERAL DEGAULLE DR
Mailing Address - Street 2:SUITE 4030
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70114-6757
Mailing Address - Country:US
Mailing Address - Phone:504-915-9590
Mailing Address - Fax:504-362-2215
Practice Address - Street 1:315 METAIRIE RD STE 200
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70005-4337
Practice Address - Country:US
Practice Address - Phone:504-915-9590
Practice Address - Fax:504-309-4964
Is Sole Proprietor?:No
Enumeration Date:2006-04-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA563103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5S695Medicare ID - Type Unspecified