Provider Demographics
NPI:1578771598
Name:TAO, YEN KIM (LCSW)
Entity Type:Individual
Prefix:
First Name:YEN
Middle Name:KIM
Last Name:TAO
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 1:4914 BISSONET DR
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70003-1138
Mailing Address - Country:US
Mailing Address - Phone:504-343-2247
Mailing Address - Fax:
Practice Address - Street 1:2955 RIDGELAKE DR STE 105
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-4947
Practice Address - Country:US
Practice Address - Phone:504-579-3937
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA63781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical