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NPI Code Detail

MEDICARE: JOHN D NOSACKA LCSW

MEDICARE:   JOHN D NOSACKA  LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker3995LA

General Provider Information

NPI Number : 1174718811
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN D NOSACKA LCSW
Provider Business Mailing Address
First Line : PO BOX 66558
Second Line :
City : BATON ROUGE
State : LA
Zip : 70896-6558
Country : US
Telephone Number : 225-922-2700
Fax Number :
Provider Business Practice Location Address
First Line : 2751 WOODDALE BLVD STE A
Second Line :
City : BATON ROUGE
State : LA
Zip : 70805-7567
Country : US
Telephone Number : 225-925-1906
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2007
Last Update Date : 09/12/2025

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Directions to “ JOHN D NOSACKA LCSW” Practice Location

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