Healthcare Provider Details

I. General information

NPI: 1821560186
Provider Name (Legal Business Name): STEPHANIE SPILBERGER HARRIS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/27/2018
Last Update Date: 08/30/2023
Certification Date: 08/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2331 CAREY ST
SLIDELL LA
70458-3627
US

IV. Provider business mailing address

2331 CAREY ST
SLIDELL LA
70458-3627
US

V. Phone/Fax

Practice location:
  • Phone: 985-646-6406
  • Fax: 985-646-6460
Mailing address:
  • Phone: 985-646-6406
  • Fax: 985-646-6460

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number9574
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number9574
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: