Provider Demographics
NPI:1932380524
Name:HEARNE, CRIS
Entity Type:Individual
Prefix:
First Name:CRIS
Middle Name:
Last Name:HEARNE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:328 NASHVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-2111
Mailing Address - Country:US
Mailing Address - Phone:504-899-2771
Mailing Address - Fax:
Practice Address - Street 1:328 NASHVILLE AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-2111
Practice Address - Country:US
Practice Address - Phone:504-899-2771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-24
Last Update Date:2007-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2223101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional