Provider Demographics
NPI:1588476949
Name:GUILLOT, EMMANUEL J IV (LMSW)
Entity type:Individual
Prefix:
First Name:EMMANUEL
Middle Name:J
Last Name:GUILLOT
Suffix:IV
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:MANNY
Other - Middle Name:J
Other - Last Name:GUILLOT
Other - Suffix:IV
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3200 RIDGELAKE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-4959
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3200 RIDGELAKE DR
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-4963
Practice Address - Country:US
Practice Address - Phone:150-458-1433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-23
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA18354104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker