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General NPI Number Information
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NPI Number | 1679638720
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Entity Type | Individual
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Provider Name | TODD DAVID ULMER LCSW, CCGC
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Gender | Male
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Dates
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Enumeration Date | 12/27/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 8318 JEFFERSON HWY SUITE A
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City | BATON ROUGE
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State | LA
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Zip | 70809-1624
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Country | US
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Telephone | 225-266-8261
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Fax | 225-924-5611
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Provider Business Mailing Address
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Address Line | 10019 E GRONER AVE
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City | BATON ROUGE
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State | LA
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Zip | 70809-3819
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Country | US
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Telephone | 225-293-5587
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CCGC 113
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW 3782
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License Number State | LA
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