Provider Demographics
NPI:1841345683
Name:MAYEUX, CHARLES LOUIS (LCSW)
Entity type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:LOUIS
Last Name:MAYEUX
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 1:10220 AZROK
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-3211
Mailing Address - Country:US
Mailing Address - Phone:225-293-0990
Mailing Address - Fax:985-543-4135
Practice Address - Street 1:15785 MEDICAL ARTS PLAZA
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-1447
Practice Address - Country:US
Practice Address - Phone:985-543-4080
Practice Address - Fax:985-543-4135
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA8771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA877OtherLCSW
LA8148Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER