MEDICARE: JAMICA S SCOTT RSW

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	104100000X	Social Worker		LA

General Provider Information

NPI Number	:	1316593403
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMICA S SCOTT RSW

Provider Business Mailing Address
First Line	:	7175 CARLENE AVE
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70811-4412
Country	:	US
Telephone Number	:	225-485-4840
Fax Number	:

Provider Business Practice Location Address
First Line	:	2133 SILVERSIDE DR STE F
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70808-4179
Country	:	US
Telephone Number	:	225-250-5677
Fax Number	:

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

Provider Enumeration Date	:	08/14/2019
Last Update Date	:	08/14/2019

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