Provider Demographics
NPI:1881967115
Name:JAUNET, LYDIA GAMBEL (LMSW)
Entity type:Individual
Prefix:
First Name:LYDIA
Middle Name:GAMBEL
Last Name:JAUNET
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 1:433 METAIRIE RD STE 615
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70005-4326
Mailing Address - Country:US
Mailing Address - Phone:504-833-6730
Mailing Address - Fax:504-833-6731
Practice Address - Street 1:433 METAIRIE RD STE 615
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70005-4326
Practice Address - Country:US
Practice Address - Phone:504-833-6730
Practice Address - Fax:504-833-6731
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-16
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA7747104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker