Provider Demographics
NPI:1972029874
Name:PHILLIPS, ANN K (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:K
Last Name:PHILLIPS
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 1:15525 PINEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PRIDE
Mailing Address - State:LA
Mailing Address - Zip Code:70770-9637
Mailing Address - Country:US
Mailing Address - Phone:225-305-3540
Mailing Address - Fax:
Practice Address - Street 1:12090 S HARRELLS FERRY RD STE M
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-2470
Practice Address - Country:US
Practice Address - Phone:225-305-3540
Practice Address - Fax:225-262-5822
Is Sole Proprietor?:No
Enumeration Date:2017-08-22
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health