Provider Demographics
NPI:1356768121
Name:HASSENBOEHLER, LYN (LCSW)
Entity type:Individual
Prefix:
First Name:LYN
Middle Name:
Last Name:HASSENBOEHLER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:EVELYN
Other - Middle Name:LOUDEN
Other - Last Name:HASSENBOEHLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 959
Mailing Address - Street 2:
Mailing Address - City:PRAIRIEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70769-0959
Mailing Address - Country:US
Mailing Address - Phone:225-456-0093
Mailing Address - Fax:888-494-0963
Practice Address - Street 1:37292 MARKET PLACE DR STE C
Practice Address - Street 2:
Practice Address - City:PRAIRIEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70769-3487
Practice Address - Country:US
Practice Address - Phone:225-456-0093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-18
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA33401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical