Healthcare Provider Details

I. General information

NPI: 1760202139
Provider Name (Legal Business Name): SEAN VANHILLE PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2024
Last Update Date: 09/13/2026
Certification Date: 09/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 OCHSNER BLVD
COVINGTON LA
70433-8107
US

IV. Provider business mailing address

830 CAPISTRANO CT
COVINGTON LA
70433-0883
US

V. Phone/Fax

Practice location:
  • Phone: 985-338-5254
  • Fax:
Mailing address:
  • Phone: 435-868-7374
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number661245
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number1758
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: