Provider Demographics
NPI:1659545093
Name:SARA MANOUCHEHRI, MSW, LCSW LLC
Entity Type:Organization
Organization Name:SARA MANOUCHEHRI, MSW, LCSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:MANOUCHEHRI
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-BACS
Authorized Official - Phone:504-312-2911
Mailing Address - Street 1:330 N JEFF DAVIS PKWY
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-5312
Mailing Address - Country:US
Mailing Address - Phone:504-312-2911
Mailing Address - Fax:
Practice Address - Street 1:330 N JEFF DAVIS PKWY
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-5312
Practice Address - Country:US
Practice Address - Phone:504-312-2911
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-16
Last Update Date:2011-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA8116251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health