MEDICARE: FUSION SERVICES,LLC

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	4023	LA

General Provider Information

NPI Number	:	1891703294
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FUSION SERVICES,LLC

Provider Business Mailing Address
First Line	:	3750 GOVERNMENT ST
Second Line	:	STE 5
City	:	ALEXANDRIA
State	:	LA
Zip	:	71302-3251
Country	:	US
Telephone Number	:	225-205-6015
Fax Number	:

Provider Business Practice Location Address
First Line	:	3750 GOVERNMENT STREET
Second Line	:
City	:	ALEXANDRIA
State	:	LA
Zip	:	71302
Country	:	US
Telephone Number	:	225-205-6015
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. SONYA DENISE WILLIAMS
Credential	:
Telephone Number	:	225-205-6015

Provider Enumeration Date	:	08/03/2006
Last Update Date	:	07/02/2008

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