Provider Demographics
NPI:1659627768
Name:CLEMONS, KAY (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:KAY
Middle Name:
Last Name:CLEMONS
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5920 RICKEY ST
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70003-2122
Mailing Address - Country:US
Mailing Address - Phone:504-914-3102
Mailing Address - Fax:504-455-5244
Practice Address - Street 1:433 METAIRIE RD
Practice Address - Street 2:SUITE 315
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70005-4333
Practice Address - Country:US
Practice Address - Phone:504-914-3102
Practice Address - Fax:504-455-5244
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-25
Last Update Date:2012-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA59861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical