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General NPI Number Information
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NPI Number | 1164768263
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Entity Type | Individual
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Provider Name | AMY ANN MENESES LCSW, C-SSWS
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Gender | Female
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Dates
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Enumeration Date | 12/17/2012
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Last Update Date | 12/17/2012
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Provider Practice Location Address
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Address Line | 601 TEE MA RD.
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City | CARENCRO
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State | LA
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Zip | 70520
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Country | US
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Telephone | 337-521-7640
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Fax |
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Provider Business Mailing Address
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Address Line | 152 KNOLLWOOD DR
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City | LAFAYETTE
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State | LA
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Zip | 70506-6054
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Country | US
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Telephone | 337-739-7796
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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 | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number | 8272
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License Number State | LA
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