Provider Demographics
NPI:1790063915
Name:AUSTIN, DEBRA ALEXANDER (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:ALEXANDER
Last Name:AUSTIN
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 1:4445 DALE ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70126-4036
Mailing Address - Country:US
Mailing Address - Phone:504-214-8968
Mailing Address - Fax:504-304-2682
Practice Address - Street 1:4445 DALE ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70126-4036
Practice Address - Country:US
Practice Address - Phone:504-214-8968
Practice Address - Fax:504-304-2682
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-22
Last Update Date:2011-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1559174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist