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NPI Code Detail

MEDICARE: MS. CYNTHIA ANN THIBODEAUX LCSW

MEDICARE: MS. CYNTHIA ANN THIBODEAUX 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 Worker3528LA

General Provider Information

NPI Number : 1427244185
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CYNTHIA ANN THIBODEAUX LCSW
Provider Business Mailing Address
First Line : 2601 TULANE AVE
Second Line : 8TH FLOOR
City : NEW ORLEANS
State : LA
Zip : 70119-7462
Country : US
Telephone Number : 504-826-2010
Fax Number : 504-658-9401
Provider Business Practice Location Address
First Line : 2601 TULANE AVE
Second Line : 8TH FLOOR
City : NEW ORLEANS
State : LA
Zip : 70119-7462
Country : US
Telephone Number : 504-826-2010
Fax Number : 504-658-9401
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/17/2007
Last Update Date : 09/17/2007

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