Healthcare Provider Details

I. General information

NPI: 1417005851
Provider Name (Legal Business Name): PRISCILLA LYNN SENN I LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: PRISCILLA LYNN SENN I LCSW

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 06/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2404 DUVAL DR 2404 DUVAL DR.
MONROE LA
71201-2986
US

IV. Provider business mailing address

2404 DUVAL DRIVE 2404 DUVAL DRIVE
MONROE LA
71201-2986
US

V. Phone/Fax

Practice location:
  • Phone: 318-329-3933
  • Fax: 318-322-1134
Mailing address:
  • Phone: 131-832-9393
  • Fax: 131-832-2113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number3399
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: