Provider Demographics
NPI:1205256302
Name:LAINIE BREAUX, LLC
Entity type:Organization
Organization Name:LAINIE BREAUX, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:HELENE
Authorized Official - Middle Name:WALTZER
Authorized Official - Last Name:BREAUX
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:504-838-9919
Mailing Address - Street 1:3500 N CAUSEWAY BLVD
Mailing Address - Street 2:SUITE 1410
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-3527
Mailing Address - Country:US
Mailing Address - Phone:504-838-9919
Mailing Address - Fax:504-834-3101
Practice Address - Street 1:3500 N CAUSEWAY BLVD
Practice Address - Street 2:SUITE 1410
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-3527
Practice Address - Country:US
Practice Address - Phone:504-838-9919
Practice Address - Fax:504-834-3101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-16
Last Update Date:2014-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5126101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty