Healthcare Provider Details

I. General information

NPI: 1013042811
Provider Name (Legal Business Name): DAVID F TALMAGE L.C.S.W., B.C.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5001 HIGHWAY 190 EAST SERVICE RD SUITE C4-5
COVINGTON LA
70433-4930
US

IV. Provider business mailing address

5001 HIGHWAY 190 EAST SERVICE RD SUITE C4-5
COVINGTON LA
70433-4930
US

V. Phone/Fax

Practice location:
  • Phone: 985-893-7608
  • Fax: 985-893-7608
Mailing address:
  • Phone: 985-893-7608
  • Fax: 985-893-7608

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number971
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: