Individual
MR. MICHAEL ANTHONY BREAUX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1585 3RD ST BLDG 1170, FORT POLK, LA 71459-5102
(337) 531-2852
(337) 531-3025
Mailing address
1585 3RD ST, OFFICE 6065, FORT POLK, LA 71459-5102
(337) 531-2113
(337) 531-3025
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
10225
LA
1041C0700X
Clinical Social Worker
2019003078
MO
1041C0700X
Clinical Social Worker
BBH-LCSW-LIC-19106
MT
1041C0700X
Clinical Social Worker
LCSW-36892
ID
1041C0700X
Clinical Social Worker
LSW0000007774
TN
Other
Enumeration date
12/19/2012
Last updated
01/02/2025
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