Provider Demographics
NPI:1306677240
Name:DEJEAN, ERNEST JR (RSW)
Entity type:Individual
Prefix:MR
First Name:ERNEST
Middle Name:
Last Name:DEJEAN
Suffix:JR
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 1:131 S ROBERTSON ST STE 103410TH
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-2807
Mailing Address - Country:US
Mailing Address - Phone:504-988-5413
Mailing Address - Fax:504-988-6013
Practice Address - Street 1:4720 S I 10 SERVICE RD W STE 401
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-1242
Practice Address - Country:US
Practice Address - Phone:504-988-5435
Practice Address - Fax:504-988-5442
Is Sole Proprietor?:No
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA7411104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker