Provider Demographics
NPI:1598894511
Name:AUBRY, M. ANTHONY (GSW, LAC, AADC)
Entity Type:Individual
Prefix:MR
First Name:M.
Middle Name:ANTHONY
Last Name:AUBRY
Suffix:
Gender:M
Credentials:GSW, LAC, AADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 ROBERT E LEE BLVD
Mailing Address - Street 2:NO. 267
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70124-2534
Mailing Address - Country:US
Mailing Address - Phone:504-858-2757
Mailing Address - Fax:504-568-2018
Practice Address - Street 1:611 N RAMPART ST
Practice Address - Street 2:BUILDING NO. 4
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-3505
Practice Address - Country:US
Practice Address - Phone:504-858-2757
Practice Address - Fax:504-568-2018
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA777101YA0400X
LA60481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical