Provider Demographics
NPI:1205059631
Name:BARRILLEAUX, J CHRIS (LCSW)
Entity type:Individual
Prefix:MR
First Name:J
Middle Name:CHRIS
Last Name:BARRILLEAUX
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:921 CAROLINE ST
Mailing Address - Street 2:
Mailing Address - City:THIBODAUX
Mailing Address - State:LA
Mailing Address - Zip Code:70301-2809
Mailing Address - Country:US
Mailing Address - Phone:985-803-1000
Mailing Address - Fax:
Practice Address - Street 1:921 CAROLINE ST
Practice Address - Street 2:
Practice Address - City:THIBODAUX
Practice Address - State:LA
Practice Address - Zip Code:70301-2809
Practice Address - Country:US
Practice Address - Phone:985-803-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA73331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical