Provider Demographics
NPI:1952650376
Name:DELEE, TARA RISPONE (LCSW)
Entity Type:Individual
Prefix:
First Name:TARA
Middle Name:RISPONE
Last Name:DELEE
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 1:12249 HOOPER ROAD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70818
Mailing Address - Country:US
Mailing Address - Phone:225-588-5161
Mailing Address - Fax:
Practice Address - Street 1:12249 HOOPER ROAD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70818
Practice Address - Country:US
Practice Address - Phone:225-588-5161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-30
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA86221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical