Dermody, Ian Matthew

Dermody, Ian Matthew is an sole proprietor health care provider with primary practice located at 252 Hector Ave Ste A , Gretna LA 70056-2548. He recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as his primary health care specialty. Dermody, Ian Matthew can be contacted via phone (504) 435-1444.

Contact Information

Primary practice address
252 Hector Ave Ste A Gretna LA 70056-2548
Phone: (504) 435-1444
Fax: (504) 372-2775
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 6759 Louisiana

Profile Details

NPI number 1952863243
LBN Legal business name Dermody, Ian Matthew
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 4th, 2019
Last updated Apr 4th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1952863243 NPPES
Louisiana MEDICAID 82-2459201

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