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NPI Code Detail

MEDICARE: MRS. CYNTHIA BOURGEOIS ABED LCSW-BACS

MEDICARE: MRS. CYNTHIA BOURGEOIS ABED LCSW-BACS
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 WorkerLA

General Provider Information

NPI Number : 1407225303
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CYNTHIA BOURGEOIS ABED LCSW-BACS
Provider Business Mailing Address
First Line : 30826 LINDER RD
Second Line :
City : DENHAM SPRINGS
State : LA
Zip : 70726-8507
Country : US
Telephone Number : 225-665-7878
Fax Number : 225-665-7856
Provider Business Practice Location Address
First Line : 30826 LINDER RD
Second Line :
City : DENHAM SPRINGS
State : LA
Zip : 70726-8507
Country : US
Telephone Number : 225-665-7878
Fax Number : 225-665-7856
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2015
Last Update Date : 09/21/2015

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