Provider Demographics
NPI:1245556109
Name:WARCISKI, DONNA BEASON (LCSW)
Entity type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:BEASON
Last Name:WARCISKI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1530 VERNA ST
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70364-2874
Mailing Address - Country:US
Mailing Address - Phone:985-860-8590
Mailing Address - Fax:985-857-3782
Practice Address - Street 1:1386 W TUNNEL BLVD
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360-2731
Practice Address - Country:US
Practice Address - Phone:985-872-4553
Practice Address - Fax:985-872-1803
Is Sole Proprietor?:No
Enumeration Date:2010-04-15
Last Update Date:2011-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA103121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical