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General NPI Number Information
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NPI Number | 1922080902
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Entity Type | Individual
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Provider Name | MALCOLM JAMES DUGAS JR. MSW,LCSW,ACSW
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Gender | Male
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Dates
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Enumeration Date | 11/16/2005
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Last Update Date | 03/31/2015
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Provider Practice Location Address
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Address Line | 209 BAYOU GARDENS BLVD. SUITE 403
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City | HOUMA
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State | LA
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Zip | 70364-1420
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Country | US
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Telephone | 985-209-1974
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Fax | 985-872-4707
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Provider Business Mailing Address
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Address Line | PO BOX 20355
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City | HOUMA
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State | LA
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Zip | 70360-0355
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Country | US
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Telephone | 985-209-1974
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Fax | 985-872-4707
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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 | 4615
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License Number State | LA
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