Provider Demographics
NPI:1992999429
Name:BREAUX, HEIDI MARCIA (LCSW)
Entity type:Individual
Prefix:MISS
First Name:HEIDI
Middle Name:MARCIA
Last Name:BREAUX
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:HEIDI
Other - Middle Name:
Other - Last Name:PECK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1415 TULANE AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-2600
Mailing Address - Country:US
Mailing Address - Phone:504-235-1499
Mailing Address - Fax:
Practice Address - Street 1:1415 TULANE AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-2600
Practice Address - Country:US
Practice Address - Phone:504-235-1499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-28
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0782391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical