Healthcare Provider Details

I. General information

NPI: 1396491908
Provider Name (Legal Business Name): ANDREW JOHN PREJEAN LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2022
Last Update Date: 03/25/2025
Certification Date: 03/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 N CAUSEWAY BLVD STE 435
METAIRIE LA
70002-3541
US

IV. Provider business mailing address

822 S CLEARVIEW PKWY
HARAHAN LA
70123-3401
US

V. Phone/Fax

Practice location:
  • Phone: 985-377-9828
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number16390
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: