MEDICARE: PHOENIX DELORES MORALES 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
1	1041C0700X	Clinical Social Worker	14286	LA

General Provider Information

NPI Number	:	1679146898
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PHOENIX DELORES MORALES LCSW

Provider Business Mailing Address
First Line	:	3149 TRAFALGAR ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70119-2033
Country	:	US
Telephone Number	:	616-401-9047
Fax Number	:

Provider Business Practice Location Address
First Line	:	3149 TRAFALGAR ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70119-2033
Country	:	US
Telephone Number	:	616-401-9047
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/24/2021
Last Update Date	:	07/24/2021

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Directions to “ PHOENIX DELORES MORALES LCSW” Practice Location

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