Provider Demographics
NPI:1962701508
Name:DEWHIRST, ROBYN DENENEA (LCSW, LAC)
Entity type:Individual
Prefix:MS
First Name:ROBYN
Middle Name:DENENEA
Last Name:DEWHIRST
Suffix:
Gender:F
Credentials:LCSW, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2626 CHARLES DRIVE
Mailing Address - Street 2:
Mailing Address - City:CHALMETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70043
Mailing Address - Country:US
Mailing Address - Phone:504-278-4006
Mailing Address - Fax:504-278-4007
Practice Address - Street 1:2626 CHARLES DRIVE
Practice Address - Street 2:
Practice Address - City:CHALMETTE
Practice Address - State:LA
Practice Address - Zip Code:70043
Practice Address - Country:US
Practice Address - Phone:504-278-4006
Practice Address - Fax:504-278-4007
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-22
Last Update Date:2013-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1256101YA0400X
LA43591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)