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NPI Code Detail

MEDICARE: MRS. RUBY DARLENE ABBOTT LCSW, BACS

MEDICARE:  MRS. RUBY DARLENE ABBOTT  LCSW, BACS
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
11041C0700XClinical Social Worker2990LA

General Provider Information

NPI Number : 1497220404
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. RUBY DARLENE ABBOTT LCSW, BACS
Provider Business Mailing Address
First Line : 33849 CANE MARKET RD
Second Line :
City : WALKER
State : LA
Zip : 70785-4015
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 10425 PLAZA AMERICANA DR
Second Line :
City : BATON ROUGE
State : LA
Zip : 70816-8188
Country : US
Telephone Number : 225-810-4719
Fax Number : 225-810-4722
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2018
Last Update Date : 10/05/2018

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Directions to “ MRS. RUBY DARLENE ABBOTT LCSW, BACS” Practice Location

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