Provider Demographics
NPI:1619699683
Name:BREAUX, DEBBIE B (LCSW)
Entity Type:Individual
Prefix:
First Name:DEBBIE
Middle Name:B
Last Name:BREAUX
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 1:10720 LINKWOOD CT APT 327
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-2939
Mailing Address - Country:US
Mailing Address - Phone:225-603-1208
Mailing Address - Fax:
Practice Address - Street 1:331 GRANDPRE ST
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70802-5919
Practice Address - Country:US
Practice Address - Phone:225-283-1168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-15
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA159681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical