Provider Demographics
NPI:1992898316
Name:URSIN, MARCELLA L (MSW, LCSW)
Entity type:Individual
Prefix:MRS
First Name:MARCELLA
Middle Name:L
Last Name:URSIN
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 METAIRIE CT
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-6312
Mailing Address - Country:US
Mailing Address - Phone:504-292-5632
Mailing Address - Fax:
Practice Address - Street 1:2600 METAIRIE CT
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-6312
Practice Address - Country:US
Practice Address - Phone:504-292-5632
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-30
Last Update Date:2016-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA40761041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5DW33Medicare PIN