Provider Demographics
NPI:1447213103
Name:DUHON, THAIS LORIO (LCSW)
Entity type:Individual
Prefix:
First Name:THAIS
Middle Name:LORIO
Last Name:DUHON
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 1:422 GLENDALE DR
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70001-5530
Mailing Address - Country:US
Mailing Address - Phone:504-833-0230
Mailing Address - Fax:
Practice Address - Street 1:118 RIDGELAKE DR
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-5312
Practice Address - Country:US
Practice Address - Phone:504-833-0230
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA25761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1149560Medicaid
LA5X506Medicare ID - Type Unspecified