Provider Demographics
NPI:1740428655
Name:FRYOU, ROLAND MARK (LCSW)
Entity Type:Individual
Prefix:
First Name:ROLAND
Middle Name:MARK
Last Name:FRYOU
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7407A SAINT BERNARD HWY
Mailing Address - Street 2:
Mailing Address - City:ARABI
Mailing Address - State:LA
Mailing Address - Zip Code:70032-1832
Mailing Address - Country:US
Mailing Address - Phone:504-278-7401
Mailing Address - Fax:504-278-7475
Practice Address - Street 1:7407A SAINT BERNARD HWY
Practice Address - Street 2:
Practice Address - City:ARABI
Practice Address - State:LA
Practice Address - Zip Code:70032-1832
Practice Address - Country:US
Practice Address - Phone:504-278-7401
Practice Address - Fax:504-278-7475
Is Sole Proprietor?:No
Enumeration Date:2009-01-30
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA31221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical