Provider Demographics
NPI:1578195798
Name:SCHUTTE, JOHANNA GERTRUIDA (MSW,LCSW)
Entity Type:Individual
Prefix:
First Name:JOHANNA
Middle Name:GERTRUIDA
Last Name:SCHUTTE
Suffix:
Gender:F
Credentials:MSW,LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 METAIRIE LAWN DR STE A
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70001-5448
Mailing Address - Country:US
Mailing Address - Phone:504-722-0656
Mailing Address - Fax:
Practice Address - Street 1:121 METAIRIE LAWN DR STE A
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-5448
Practice Address - Country:US
Practice Address - Phone:504-722-0656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-05
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical