MEDICARE: ROBERT MARION KERNE LCSW AND LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	1771	LA
2	106H00000X	Marriage & Family Therapist	MFT 905	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053485425
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT MARION KERNE LCSW AND LMFT

Provider Business Mailing Address
First Line	:	620 N MORRISON BLVD
Second Line	:	SUITE 4
City	:	HAMMOND
State	:	LA
Zip	:	70401-2312
Country	:	US
Telephone Number	:	985-351-3237
Fax Number	:

Provider Business Practice Location Address
First Line	:	620 N MORRISON BLVD
Second Line	:	SUITE 4
City	:	HAMMOND
State	:	LA
Zip	:	70401-2312
Country	:	US
Telephone Number	:	985-351-3237
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/20/2006
Last Update Date	:	09/11/2017

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