Provider Demographics
NPI:1679688279
Name:HEUMANN, DAISY (LCSW)
Entity type:Individual
Prefix:
First Name:DAISY
Middle Name:
Last Name:HEUMANN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 METAIRIE RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70005-4300
Mailing Address - Country:US
Mailing Address - Phone:504-837-1107
Mailing Address - Fax:985-871-9058
Practice Address - Street 1:315 METAIRIE RD
Practice Address - Street 2:SUITE 201
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70005-4300
Practice Address - Country:US
Practice Address - Phone:504-837-1107
Practice Address - Fax:985-871-9058
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA34911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5T250Medicare ID - Type Unspecified