Provider Demographics
NPI:1295210276
Name:PERRAULT, DAVID II (MA)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:PERRAULT
Suffix:II
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2701 MIDDEN DR
Mailing Address - Street 2:
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072-6611
Mailing Address - Country:US
Mailing Address - Phone:504-912-3949
Mailing Address - Fax:
Practice Address - Street 1:2401 WESTBEND PKWY STE 4070
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70114-2469
Practice Address - Country:US
Practice Address - Phone:504-363-7449
Practice Address - Fax:504-333-6252
Is Sole Proprietor?:No
Enumeration Date:2018-09-26
Last Update Date:2019-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health