Provider Demographics
NPI:1598813768
Name:FOWLER, DOREEN KUHN (LCSW)
Entity Type:Individual
Prefix:
First Name:DOREEN
Middle Name:KUHN
Last Name:FOWLER
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 1:2624 N BENGAL RD
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70003-5324
Mailing Address - Country:US
Mailing Address - Phone:504-394-5309
Mailing Address - Fax:877-902-5562
Practice Address - Street 1:720 LAFAYETTE ST
Practice Address - Street 2:
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70053-6136
Practice Address - Country:US
Practice Address - Phone:504-394-5309
Practice Address - Fax:877-902-5562
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA70281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA4H766Medicare ID - Type Unspecified