MEDICARE: DR. DAPHNE SUE CAIN PH.D., 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
1	1041C0700X	Clinical Social Worker	8671	LA

General Provider Information

NPI Number	:	1346415775
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAPHNE SUE CAIN PH.D., LCSW

Provider Business Mailing Address
First Line	:	208 LOVERS LN
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70806-5118
Country	:	US
Telephone Number	:	225-389-0009
Fax Number	:

Provider Business Practice Location Address
First Line	:	1651 THIBODEAUX AVE STE B
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70806-8271
Country	:	US
Telephone Number	:	225-216-3037
Fax Number	:	225-216-3038

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/27/2008
Last Update Date	:	04/27/2008

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