Healthcare Provider Details

I. General information

NPI: 1912726027
Provider Name (Legal Business Name): NATALIE GRACE LAZAROE LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2024
Last Update Date: 10/07/2024
Certification Date: 10/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4919 CANAL ST STE 203
NEW ORLEANS LA
70119-5878
US

IV. Provider business mailing address

10817 SHOE CREEK DR
BATON ROUGE LA
70818-4018
US

V. Phone/Fax

Practice location:
  • Phone: 504-483-9883
  • Fax: 504-508-5818
Mailing address:
  • Phone: 225-953-0255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: