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NPI Code Detail

MEDICARE: JOAN LEE GOAR LCSW

MEDICARE: JOAN LEE GOAR 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
1101YP2500XProfessional Counselor5541LA

General Provider Information

NPI Number : 1730239237
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOAN LEE GOAR LCSW
Provider Business Mailing Address
First Line : 2155 OLIVE ST
Second Line :
City : BATON ROUGE
State : LA
Zip : 70806-6621
Country : US
Telephone Number : 225-334-9063
Fax Number : 225-334-0959
Provider Business Practice Location Address
First Line : 4428 NORTH BLVD
Second Line :
City : BATON ROUGE
State : LA
Zip : 70806-3917
Country : US
Telephone Number : 225-334-9063
Fax Number : 225-334-0959
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/10/2007
Last Update Date : 07/08/2007

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Directions to “ JOAN LEE GOAR LCSW” Practice Location

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