Provider Demographics
NPI:1841674678
Name:THIERRY, MELANIE (LCSW)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:THIERRY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:MELANIE
Other - Middle Name:ANN
Other - Last Name:HARLEAUX-THIERRY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:4425 GROOM RD
Mailing Address - Street 2:
Mailing Address - City:BAKER
Mailing Address - State:LA
Mailing Address - Zip Code:70714-3046
Mailing Address - Country:US
Mailing Address - Phone:225-757-5699
Mailing Address - Fax:225-757-5845
Practice Address - Street 1:4425 GROOM RD
Practice Address - Street 2:
Practice Address - City:BAKER
Practice Address - State:LA
Practice Address - Zip Code:70714-3046
Practice Address - Country:US
Practice Address - Phone:225-757-5699
Practice Address - Fax:225-757-5845
Is Sole Proprietor?:No
Enumeration Date:2015-07-10
Last Update Date:2015-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA60111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical