Provider Demographics
NPI:1689147928
Name:BROOKS-SANVILLE, DARLENE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:DARLENE
Middle Name:
Last Name:BROOKS-SANVILLE
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 1:1937 BROOKTER ST
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70461-4824
Mailing Address - Country:US
Mailing Address - Phone:504-914-9772
Mailing Address - Fax:
Practice Address - Street 1:1937 BROOKTER ST
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70461-4824
Practice Address - Country:US
Practice Address - Phone:504-914-9772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-09
Last Update Date:2019-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA91481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical