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NPI Code Detail

MEDICARE: MR. NATHAN S BURATT LCSW

MEDICARE: MR. NATHAN S BURATT 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 Worker1938LA

General Provider Information

NPI Number : 1437263746
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. NATHAN S BURATT LCSW
Provider Business Mailing Address
First Line : 302 DULLES DR
Second Line : SUITE 1
City : LAFAYETTE
State : LA
Zip : 70506-3008
Country : US
Telephone Number : 337-262-5870
Fax Number : 337-262-1272
Provider Business Practice Location Address
First Line : 302 DULLES DR
Second Line : SUITE 1
City : LAFAYETTE
State : LA
Zip : 70506-3008
Country : US
Telephone Number : 337-262-5870
Fax Number : 337-262-1272
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/17/2006
Last Update Date : 07/08/2007

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