Provider Demographics
NPI:1558727503
Name:REBECCA STILLING LCSW A PROFESSIONAL SOCIAL WORK CORPORATION
Entity Type:Organization
Organization Name:REBECCA STILLING LCSW A PROFESSIONAL SOCIAL WORK CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:STILLING
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:504-888-0727
Mailing Address - Street 1:1908 HOUMA BLVD
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70001-2531
Mailing Address - Country:US
Mailing Address - Phone:504-888-0727
Mailing Address - Fax:504-888-0727
Practice Address - Street 1:4902 CANAL ST
Practice Address - Street 2:SUITE 404
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-5840
Practice Address - Country:US
Practice Address - Phone:504-482-8409
Practice Address - Fax:504-482-8409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-06
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA15441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty