Provider Demographics
NPI:1285776617
Name:BROYLES, NANCY H (LCSW)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:H
Last Name:BROYLES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:NANCY
Other - Middle Name:H
Other - Last Name:BROYLES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:1805 COLLEGE DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-1919
Mailing Address - Country:US
Mailing Address - Phone:225-923-3420
Mailing Address - Fax:225-922-9317
Practice Address - Street 1:1805 COLLEGE DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-1919
Practice Address - Country:US
Practice Address - Phone:225-923-3420
Practice Address - Fax:225-922-9317
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA26331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical