Provider Demographics
NPI:1386486546
Name:MARCANTEL, HALEY HEBERT
Entity type:Individual
Prefix:MRS
First Name:HALEY
Middle Name:HEBERT
Last Name:MARCANTEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:780 PELICAN WAY
Mailing Address - Street 2:WEST BATON ROUGE STUDENT SERVICES
Mailing Address - City:PORT ALLEN
Mailing Address - State:LA
Mailing Address - Zip Code:70739
Mailing Address - Country:US
Mailing Address - Phone:225-343-8405
Mailing Address - Fax:
Practice Address - Street 1:780 PELICAN WAY
Practice Address - Street 2:WEST BATON ROUGE STUDENT SERVICES
Practice Address - City:PORT ALLEN
Practice Address - State:LA
Practice Address - Zip Code:70739
Practice Address - Country:US
Practice Address - Phone:225-343-8405
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-10
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA77331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical