Provider Demographics
NPI:1982769741
Name:STAGG, THOMAS LOUIS (LCSW)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:LOUIS
Last Name:STAGG
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 1:8200 HAMPSON ST
Mailing Address - Street 2:SUITE 306
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70118-1000
Mailing Address - Country:US
Mailing Address - Phone:504-914-5945
Mailing Address - Fax:
Practice Address - Street 1:8200 HAMPSON ST
Practice Address - Street 2:SUITE 306
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70118-1000
Practice Address - Country:US
Practice Address - Phone:504-914-5945
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2009-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA86691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical