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General NPI Number Information
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NPI Number | 1063768851
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Entity Type | Individual
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Provider Name | NICOLE CROOKS LEJEUNE LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/30/2012
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Last Update Date | 05/13/2015
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Provider Practice Location Address
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Address Line | 2495 SHREVEPORT HWY
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City | PINEVILLE
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State | LA
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Zip | 71360-4044
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Country | US
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Telephone | 318-473-0010
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Fax |
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Provider Business Mailing Address
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Address Line | 1907 JOHNSON ST
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City | JENNINGS
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State | LA
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Zip | 70546-3627
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Country | US
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Telephone | 337-785-4757
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Fax |
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 10012
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License Number State | LA
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