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NPI Code Detail

MEDICARE: LACITTA MATTHEWS MSW

MEDICARE: LACITTA MATTHEWS MSW
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
1101YP2500XProfessional Counselor

General Provider Information

NPI Number : 1467101469
Entity Type Code : Individual
Provider Name (Legal Business Name) : LACITTA MATTHEWS MSW
Provider Business Mailing Address
First Line : 1925 ENTERPRISE BLVD
Second Line :
City : LAKE CHARLES
State : LA
Zip : 70601-6371
Country : US
Telephone Number : 337-429-5129
Fax Number : 337-214-2077
Provider Business Practice Location Address
First Line : 1925 ENTERPRISE BLVD
Second Line :
City : LAKE CHARLES
State : LA
Zip : 70601-6371
Country : US
Telephone Number : 337-429-5129
Fax Number : 337-214-2077
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/18/2022
Last Update Date : 03/18/2022

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