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NPI Code Detail

MEDICARE: MR. PAUL ALLAN KRAFT MSW, LCSW

MEDICARE: MR. PAUL ALLAN KRAFT MSW, 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 Worker9750LA

General Provider Information

NPI Number : 1275770455
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. PAUL ALLAN KRAFT MSW, LCSW
Provider Business Mailing Address
First Line : 178 NORTH BOULEVARD
Second Line :
City : BATON ROUGE
State : LA
Zip : 70802-0000
Country : US
Telephone Number : 225-293-6774
Fax Number : 225-291-9229
Provider Business Practice Location Address
First Line : 4428 NORTH BLVD
Second Line :
City : BATON ROUGE
State : LA
Zip : 70806-3917
Country : US
Telephone Number : 225-334-9063
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2009
Last Update Date : 01/09/2009

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