Healthcare Provider Details

I. General information

NPI: 1295005486
Provider Name (Legal Business Name): LIONEL LOUIS FASCIO II LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2012
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 CALDER ST
GRETNA LA
70053-5637
US

IV. Provider business mailing address

228 SOUTHWOOD DR
GRETNA LA
70056-7865
US

V. Phone/Fax

Practice location:
  • Phone: 504-322-7710
  • Fax: 504-322-7708
Mailing address:
  • Phone: 504-339-7701
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number6202
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6202
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: