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NPI Code Detail

MEDICARE: CHARLETTE JAVIUS

MEDICARE: CHARLETTE JAVIUS
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 Counselor
2171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1811429822
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARLETTE JAVIUS
Provider Business Mailing Address
First Line : 3173 WASHINGTON AVE
Second Line :
City : BATON ROUGE
State : LA
Zip : 70802-2178
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3173 WASHINGTON AVE
Second Line :
City : BATON ROUGE
State : LA
Zip : 70802-2178
Country : US
Telephone Number : 225-778-7678
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2017
Last Update Date : 05/28/2019

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Directions to “ CHARLETTE JAVIUS ” Practice Location

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