Provider Demographics
NPI:1043529480
Name:HEBERT, MILTON
Entity type:Individual
Prefix:MR
First Name:MILTON
Middle Name:
Last Name:HEBERT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2003 C C BEL RD
Mailing Address - Street 2:
Mailing Address - City:ELTON
Mailing Address - State:LA
Mailing Address - Zip Code:70532-5318
Mailing Address - Country:US
Mailing Address - Phone:337-584-1439
Mailing Address - Fax:
Practice Address - Street 1:2003 C C BEL RD
Practice Address - Street 2:
Practice Address - City:ELTON
Practice Address - State:LA
Practice Address - Zip Code:70532-5318
Practice Address - Country:US
Practice Address - Phone:337-584-1439
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-04
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 101YA0400X
LA5778104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)