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NPI Code Detail

MEDICARE: PATRICIA DEMOUY LCSW

MEDICARE: PATRICIA DEMOUY LCSW
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
1101YM0800XMental Health Counselor3634LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
13634OTHERLASOCIAL WORKER LICENSE

General Provider Information

NPI Number : 1417968850
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICIA DEMOUY LCSW
Provider Business Mailing Address
First Line : 1347 ARLINGTON AVE
Second Line :
City : BATON ROUGE
State : LA
Zip : 70806-6817
Country : US
Telephone Number : 225-383-2635
Fax Number : 225-924-5455
Provider Business Practice Location Address
First Line : 4727 REVERE AVE
Second Line :
City : BATON ROUGE
State : LA
Zip : 70808-3168
Country : US
Telephone Number : 225-924-0123
Fax Number : 225-924-5455
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2006
Last Update Date : 07/08/2007

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Directions to “ PATRICIA DEMOUY LCSW” Practice Location

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