Provider Demographics
NPI:1629291646
Name:BILLIOT, MARLEEN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MARLEEN
Middle Name:
Last Name:BILLIOT
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:PO BOX 2181
Mailing Address - Street 2:
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70470-2181
Mailing Address - Country:US
Mailing Address - Phone:504-261-8926
Mailing Address - Fax:985-727-3536
Practice Address - Street 1:633 ASBURY DRIVE
Practice Address - Street 2:SUITE A
Practice Address - City:MANDEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70471-6511
Practice Address - Country:US
Practice Address - Phone:504-261-8926
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2008-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA52741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1161497Medicaid
LA4C281Medicare PIN
LA1161497Medicaid