Provider Demographics
NPI:1780834986
Name:LANIER, PATTI GENNARDO (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:PATTI
Middle Name:GENNARDO
Last Name:LANIER
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 1:47285 RUFUS BANKSTON RD
Mailing Address - Street 2:
Mailing Address - City:TICKFAW
Mailing Address - State:LA
Mailing Address - Zip Code:70466-4503
Mailing Address - Country:US
Mailing Address - Phone:985-507-1368
Mailing Address - Fax:985-345-1157
Practice Address - Street 1:47285 RUFUS BANKSTON RD
Practice Address - Street 2:
Practice Address - City:TICKFAW
Practice Address - State:LA
Practice Address - Zip Code:70466-4503
Practice Address - Country:US
Practice Address - Phone:985-507-1368
Practice Address - Fax:985-345-1157
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-24
Last Update Date:2008-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3729104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker