Provider Demographics
NPI:1679341622
Name:TRUMBATURI, JOHN J III (LCSW, ACSW, C-SSWS)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:J
Last Name:TRUMBATURI
Suffix:III
Gender:M
Credentials:LCSW, ACSW, C-SSWS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1484 WOODLAND HWY
Mailing Address - Street 2:
Mailing Address - City:BELLE CHASSE
Mailing Address - State:LA
Mailing Address - Zip Code:70037-1672
Mailing Address - Country:US
Mailing Address - Phone:504-595-6067
Mailing Address - Fax:504-398-0844
Practice Address - Street 1:1484 WOODLAND HWY
Practice Address - Street 2:
Practice Address - City:BELLE CHASSE
Practice Address - State:LA
Practice Address - Zip Code:70037-1672
Practice Address - Country:US
Practice Address - Phone:504-595-6067
Practice Address - Fax:504-398-0844
Is Sole Proprietor?:No
Enumeration Date:2023-12-19
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA36801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical