Provider Demographics
NPI:1215063888
Name:BAROVECHIO, GARY L (RSW)
Entity type:Individual
Prefix:MR
First Name:GARY
Middle Name:L
Last Name:BAROVECHIO
Suffix:
Gender:M
Credentials:RSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8101 W JUDGE PEREZ DR
Mailing Address - Street 2:BLDG. B
Mailing Address - City:CHALMETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70043-1659
Mailing Address - Country:US
Mailing Address - Phone:504-278-7401
Mailing Address - Fax:504-278-7475
Practice Address - Street 1:8101 W JUDGE PEREZ DR
Practice Address - Street 2:BLDG. B
Practice Address - City:CHALMETTE
Practice Address - State:LA
Practice Address - Zip Code:70043-1659
Practice Address - Country:US
Practice Address - Phone:504-278-7401
Practice Address - Fax:504-278-7475
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA7165104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker