MEDICARE: MS. ELIZABETH MOORE STANDIFER MSW, 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	7542	OR
2	1041C0700X	Clinical Social Worker	6318	LA

General Provider Information

NPI Number	:	1942547245
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ELIZABETH MOORE STANDIFER MSW, LCSW

Provider Business Mailing Address
First Line	:	PO BOX 41151
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70835-1151
Country	:	US
Telephone Number	:	225-317-4365
Fax Number	:

Provider Business Practice Location Address
First Line	:	4358 S JEFFREY DR STE A
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70816-4196
Country	:	US
Telephone Number	:	225-317-4365
Fax Number	:

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

Provider Enumeration Date	:	01/08/2013
Last Update Date	:	06/19/2025

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