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NPI Code Detail

MEDICARE: STANLEY MONG LCSW,BCD

MEDICARE:   STANLEY  MONG  LCSW,BCD
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 Worker1125LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1518027317
Entity Type Code : Individual
Provider Name (Legal Business Name) : STANLEY MONG LCSW,BCD
Provider Business Mailing Address
First Line : 4615 GOVERNMENT ST BLDG 2
Second Line :
City : BATON ROUGE
State : LA
Zip : 70806-5820
Country : US
Telephone Number : 225-925-1768
Fax Number : 225-922-0771
Provider Business Practice Location Address
First Line : 4615 GOVERNMENT ST BLDG 2
Second Line :
City : BATON ROUGE
State : LA
Zip : 70806-5820
Country : US
Telephone Number : 225-925-1768
Fax Number : 225-922-0771
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2006
Last Update Date : 07/08/2007

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Directions to “ STANLEY MONG LCSW,BCD” Practice Location

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