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NPI Code Detail

MEDICARE: LARIE RENEE ACOSTA GSW

MEDICARE: LARIE RENEE ACOSTA GSW
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
1104100000XSocial Worker8693LA

General Provider Information

NPI Number : 1134289069
Entity Type Code : Individual
Provider Name (Legal Business Name) : LARIE RENEE ACOSTA GSW
Provider Business Mailing Address
First Line : PO BOX 66558
Second Line :
City : BATON ROUGE
State : LA
Zip : 70896-6558
Country : US
Telephone Number : 225-922-0445
Fax Number : 888-965-7288
Provider Business Practice Location Address
First Line : 422 COLONIAL DR
Second Line :
City : BATON ROUGE
State : LA
Zip : 70806-6505
Country : US
Telephone Number : 225-922-0478
Fax Number : 888-965-7288
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2006
Last Update Date : 09/17/2025

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Directions to “ LARIE RENEE ACOSTA GSW” Practice Location

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