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NPI Code Detail

MEDICARE: DIANA B MCCRORY LCSW

MEDICARE: DIANA B MCCRORY 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 Worker2397LA

General Provider Information

NPI Number : 1295822310
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIANA B MCCRORY LCSW
Provider Business Mailing Address
First Line : 4902 CANAL ST STE 404
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70119-5874
Country : US
Telephone Number : 504-834-6475
Fax Number : 504-834-6475
Provider Business Practice Location Address
First Line : 4902 CANAL ST STE 404
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70119-5874
Country : US
Telephone Number : 504-834-6475
Fax Number : 504-834-6475
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/09/2006
Last Update Date : 04/03/2024

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