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NPI Code Detail

MEDICARE: FALYNN BAHETH LMSW

MEDICARE: FALYNN BAHETH LMSW
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
1106S00000XBehavior Technician20-114547FL
2104100000XSocial Worker13254LA

General Provider Information

NPI Number : 1376087999
Entity Type Code : Individual
Provider Name (Legal Business Name) : FALYNN BAHETH LMSW
Provider Business Mailing Address
First Line : 7125 NORTHAMPTON DR
Second Line :
City : BATON ROUGE
State : LA
Zip : 70811-1732
Country : US
Telephone Number : 225-773-1570
Fax Number :
Provider Business Practice Location Address
First Line : 80 COLLEGE BLVD E
Second Line :
City : NICEVILLE
State : FL
Zip : 32578-1343
Country : US
Telephone Number : 850-279-3000
Fax Number : 850-389-2269
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/16/2016
Last Update Date : 03/12/2020

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Directions to “ FALYNN BAHETH LMSW” Practice Location

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