Provider Demographics
NPI:1528258563
Name:BORNE, HEATH F (MSW, GSW)
Entity type:Individual
Prefix:MR
First Name:HEATH
Middle Name:F
Last Name:BORNE
Suffix:
Gender:M
Credentials:MSW, GSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3708 LOYOLA DR APT 113
Mailing Address - Street 2:
Mailing Address - City:KENNER
Mailing Address - State:LA
Mailing Address - Zip Code:70065-7717
Mailing Address - Country:US
Mailing Address - Phone:504-400-6208
Mailing Address - Fax:
Practice Address - Street 1:2121 RIDGELAKE DR
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-2080
Practice Address - Country:US
Practice Address - Phone:504-838-5002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-26
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA87751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical