Provider Demographics
NPI:1811232200
Name:HARE, JAMIE PRIMEAUX (LCSW)
Entity type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:PRIMEAUX
Last Name:HARE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 RUE IBERVILLE
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-3295
Mailing Address - Country:US
Mailing Address - Phone:337-521-7122
Mailing Address - Fax:
Practice Address - Street 1:202 RUE IBERVILLE
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-3295
Practice Address - Country:US
Practice Address - Phone:337-521-7122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-11
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA112491041C0700X, 1041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical