Provider Demographics
NPI:1174053995
Name:BROOKS, HEATHER KINNEY (LMSW)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:KINNEY
Last Name:BROOKS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4103 LAC COUTURE DR
Mailing Address - Street 2:
Mailing Address - City:HARVEY
Mailing Address - State:LA
Mailing Address - Zip Code:70058
Mailing Address - Country:US
Mailing Address - Phone:504-368-9935
Mailing Address - Fax:504-368-9918
Practice Address - Street 1:4103 LAC COUTURE DR
Practice Address - Street 2:
Practice Address - City:HARVEY
Practice Address - State:LA
Practice Address - Zip Code:70058
Practice Address - Country:US
Practice Address - Phone:504-368-9935
Practice Address - Fax:504-368-9918
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-14
Last Update Date:2021-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA11193104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker