Provider Demographics
NPI:1457775009
Name:LAWRENCE, MISTY (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:MISTY
Middle Name:
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415A W MORALES ST
Mailing Address - Street 2:
Mailing Address - City:CHALMETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70043-3036
Mailing Address - Country:US
Mailing Address - Phone:504-495-9316
Mailing Address - Fax:
Practice Address - Street 1:415 W MORALES ST APT A
Practice Address - Street 2:
Practice Address - City:CHALMETTE
Practice Address - State:LA
Practice Address - Zip Code:70043-3036
Practice Address - Country:US
Practice Address - Phone:504-495-9316
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-18
Last Update Date:2022-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X, 171M00000X
LA12470171M00000X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator