MEDICARE: MRS. MEGAN CAPONE LOWENBURG 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
1	1041C0700X	Clinical Social Worker	10773	LA

General Provider Information

NPI Number	:	1578969614
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MEGAN CAPONE LOWENBURG LCSW

Provider Business Mailing Address
First Line	:	2051 8TH ST
Second Line	:
City	:	HARVEY
State	:	LA
Zip	:	70058-4001
Country	:	US
Telephone Number	:	504-368-1944
Fax Number	:	504-368-9784

Provider Business Practice Location Address
First Line	:	2051 8TH ST
Second Line	:
City	:	HARVEY
State	:	LA
Zip	:	70058-4001
Country	:	US
Telephone Number	:	504-368-1944
Fax Number	:	504-368-9784

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

Provider Enumeration Date	:	11/18/2014
Last Update Date	:	11/18/2014

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