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General NPI Number Information
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NPI Number | 1003818311
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Entity Type | Individual
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Provider Name | SANDRA S MATHEWS LCSW
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Gender | Female
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Dates
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Enumeration Date | 06/01/2005
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 218 RUE LOUIS XIV STE A
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City | LAFAYETTE
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State | LA
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Zip | 70508-5766
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Country | US
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Telephone | 337-988-1271
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Fax | 337-988-1272
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Provider Business Mailing Address
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Address Line | 125 GREEN OAKS DR
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City | LAFAYETTE
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State | LA
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Zip | 70503-2719
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Country | US
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Telephone | 337-298-5218
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Fax | 337-289-6944
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 1706
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License Number State | LA
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