Provider Demographics
NPI:1609170869
Name:YUSLUM, JUDY HAMILTON (MSW,LCSW)
Entity Type:Individual
Prefix:
First Name:JUDY
Middle Name:HAMILTON
Last Name:YUSLUM
Suffix:
Gender:F
Credentials:MSW,LCSW
Other - Prefix:
Other - First Name:JUDITH
Other - Middle Name:HAMILTON
Other - Last Name:YUSLUM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW, LCSW
Mailing Address - Street 1:14232 TROY DUPLESSIS RD
Mailing Address - Street 2:
Mailing Address - City:GONZALES
Mailing Address - State:LA
Mailing Address - Zip Code:70737-5915
Mailing Address - Country:US
Mailing Address - Phone:225-744-3308
Mailing Address - Fax:
Practice Address - Street 1:14232 TROY DUPLESSIS RD
Practice Address - Street 2:
Practice Address - City:GONZALES
Practice Address - State:LA
Practice Address - Zip Code:70737-5915
Practice Address - Country:US
Practice Address - Phone:225-744-3308
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-03
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA38891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical