Provider Demographics
NPI:1912200304
Name:KERR, VIVISON HERMAN JR
Entity Type:Individual
Prefix:MR
First Name:VIVISON
Middle Name:HERMAN
Last Name:KERR
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7020 LAKE BARRINGTON DR
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70128-2221
Mailing Address - Country:US
Mailing Address - Phone:540-258-7749
Mailing Address - Fax:
Practice Address - Street 1:7020 LAKE BARRINGTON DR
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70128-2221
Practice Address - Country:US
Practice Address - Phone:540-258-7749
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-07
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health