Provider Demographics
NPI:1205285731
Name:COLLETT, WILLIAM H (LCSW)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:H
Last Name:COLLETT
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 1:8752 QUARTERS LAKE RD
Mailing Address - Street 2:BLDG 9
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-7306
Mailing Address - Country:US
Mailing Address - Phone:225-922-9122
Mailing Address - Fax:225-922-9125
Practice Address - Street 1:8752 QUARTERS LAKE RD
Practice Address - Street 2:BLDG 9
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-7306
Practice Address - Country:US
Practice Address - Phone:225-922-9122
Practice Address - Fax:225-922-9125
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-06
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA56581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical