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NPI Code Detail

MEDICARE: BRANDY NUNNERY LCSW

MEDICARE: BRANDY NUNNERY 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 WorkerCSW005151GA
2171M00000XCase Manager/Care Coordinator15748LA

General Provider Information

NPI Number : 1366833501
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRANDY NUNNERY LCSW
Provider Business Mailing Address
First Line : 14635 S HARRELLS FERRY RD STE 3A
Second Line :
City : BATON ROUGE
State : LA
Zip : 70816-2960
Country : US
Telephone Number : 770-912-1195
Fax Number :
Provider Business Practice Location Address
First Line : 14635 S HARRELLS FERRY RD STE 3A
Second Line :
City : BATON ROUGE
State : LA
Zip : 70816-2960
Country : US
Telephone Number : 770-912-1195
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/10/2015
Last Update Date : 08/16/2023

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