Provider Demographics
NPI:1588436687
Name:BRACKEN, DIONNE M (MSW,CSW, MA)
Entity type:Individual
Prefix:
First Name:DIONNE
Middle Name:M
Last Name:BRACKEN
Suffix:
Gender:
Credentials:MSW,CSW, MA
Other - Prefix:
Other - First Name:DIONNE
Other - Middle Name:MARIE
Other - Last Name:BRACKEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW,CSW,MA
Mailing Address - Street 1:2550 BELLE CHASSE HWY STE 150
Mailing Address - Street 2:
Mailing Address - City:GRETNA
Mailing Address - State:LA
Mailing Address - Zip Code:70053-6733
Mailing Address - Country:US
Mailing Address - Phone:504-788-6801
Mailing Address - Fax:504-788-6815
Practice Address - Street 1:1400 CALDER ST
Practice Address - Street 2:
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70053-5637
Practice Address - Country:US
Practice Address - Phone:504-322-7710
Practice Address - Fax:504-322-7708
Is Sole Proprietor?:No
Enumeration Date:2023-10-23
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA10398101YP2500X
LA171M00000X
LA18076104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No171M00000XOther Service ProvidersCase Manager/Care Coordinator