Provider Demographics
NPI:1922381151
Name:TREVIGNE, BARBARA ANN (LCSW)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:ANN
Last Name:TREVIGNE
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 1:2627 NEW ORLEANS ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-1209
Mailing Address - Country:US
Mailing Address - Phone:504-319-5999
Mailing Address - Fax:
Practice Address - Street 1:2627 NEW ORLEANS ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-1209
Practice Address - Country:US
Practice Address - Phone:504-319-5999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-23
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1669174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist