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NPI Code Detail

MEDICARE: MRS. JAMIE PRIMEAUX HARE LCSW

MEDICARE: MRS. JAMIE PRIMEAUX HARE 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 Worker11249LA
21041S0200XSchool Social Worker11249LA

General Provider Information

NPI Number : 1811232200
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JAMIE PRIMEAUX HARE LCSW
Provider Business Mailing Address
First Line : 202 RUE IBERVILLE
Second Line :
City : LAFAYETTE
State : LA
Zip : 70508-3295
Country : US
Telephone Number : 337-521-7122
Fax Number :
Provider Business Practice Location Address
First Line : 202 RUE IBERVILLE
Second Line :
City : LAFAYETTE
State : LA
Zip : 70508-3295
Country : US
Telephone Number : 337-521-7122
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2012
Last Update Date : 09/18/2023

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