Healthcare Provider Details

I. General information

NPI: 1992861132
Provider Name (Legal Business Name): DARCY DEVINE SCOGGIN L.C.S.W.,A.C.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1040 CALHOUN ST HELIS BLDG. , STE. 153
NEW ORLEANS LA
70118-5914
US

IV. Provider business mailing address

1917 JOSEPH ST
NEW ORLEANS LA
70115-5004
US

V. Phone/Fax

Practice location:
  • Phone: 504-897-3344
  • Fax:
Mailing address:
  • Phone: 504-865-8308
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number3216
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: