Provider Demographics
NPI:1588663959
Name:OASE, MICHAEL LARS (LCSW)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:LARS
Last Name:OASE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1203 BARROW ST
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70360-6373
Mailing Address - Country:US
Mailing Address - Phone:985-851-3971
Mailing Address - Fax:985-873-7219
Practice Address - Street 1:1203 BARROW ST
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360-6373
Practice Address - Country:US
Practice Address - Phone:985-851-3971
Practice Address - Fax:985-873-7219
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2008-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA41151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA57926Medicare PIN
LA5X393Medicare UPIN