Healthcare Provider Details

I. General information

NPI: 1164548251
Provider Name (Legal Business Name): LOVELL M CAHILL LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 S POLK ST STE 4
COVINGTON LA
70433-2474
US

IV. Provider business mailing address

3000 SAINT CHARLES AVE APT 213
NEW ORLEANS LA
70115-4471
US

V. Phone/Fax

Practice location:
  • Phone: 985-249-7780
  • Fax: 985-249-7782
Mailing address:
  • Phone: 504-899-7929
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1474
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: