Provider Demographics
NPI:1063565133
Name:POOLEY, CAROL ANN (MSW, LCSW)
Entity type:Individual
Prefix:MS
First Name:CAROL
Middle Name:ANN
Last Name:POOLEY
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10795 MEAD RD
Mailing Address - Street 2:APT. 1715
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-2182
Mailing Address - Country:US
Mailing Address - Phone:225-296-0934
Mailing Address - Fax:
Practice Address - Street 1:15785 MEDICAL ARTS DR
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-1447
Practice Address - Country:US
Practice Address - Phone:985-543-4080
Practice Address - Fax:985-543-4090
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA50941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5094OtherMSW, LCSW