MEDICARE: INNERCORE MANAGEMENT GROUP

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

General Provider Information

NPI Number	:	1972046522
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INNERCORE MANAGEMENT GROUP

Provider Business Mailing Address
First Line	:	637 SAINT FERDINAND ST
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70802-6152
Country	:	US
Telephone Number	:	225-627-3470
Fax Number	:

Provider Business Practice Location Address
First Line	:	637 SAINT FERDINAND ST
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70802-6152
Country	:	US
Telephone Number	:	225-955-9527
Fax Number	:	225-240-1089

Authorized Official
Title or Position	:	OWNER
Name	:	MR. KENDRICK M. EBANKS
Credential	:
Telephone Number	:	225-955-9527

Provider Enumeration Date	:	11/30/2016
Last Update Date	:	04/07/2020

Similar Medicare Providers

1033076054 — PSY MATTERS, LLC
Practice Location Address:

637 SAINT FERDINAND ST
BATON ROUGE, LA
70802-6152

Practice Phone: 615-968-6608
Practice Fax:

1467885327 — MR. KENDRICK M. EBANKS LMSW
Practice Location Address:

637 SAINT FERDINAND ST
BATON ROUGE, LA
70802-6152

Practice Phone: 225-955-9527
Practice Fax:

1427403229 — MS. CARMEN ELIZABETH SPOONER LCSW-BACS
Practice Location Address:

637 SAINT FERDINAND ST
BATON ROUGE, LA
70802-6152

Practice Phone: 225-627-3470
Practice Fax: 225-240-1089

1730708942 — CARMEN ELIZABETH SPOONER
Practice Location Address:

637 SAINT FERDINAND ST
BATON ROUGE, LA
70802-6152

Practice Phone: 225-627-3470
Practice Fax: 225-240-1089

1194650978 — LOUISIANA DEPARTMENT OF HEALTH/OFFICE FOR CITIZENS WITH DEVELOPMENTAL DISABILITIES
Practice Location Address:

628 N 4TH ST
BATON ROUGE, LA
70802-5342

Practice Phone: 225-342-8725
Practice Fax:

1811823909 — ANISSA PATRICE BANKS
Practice Location Address:

3173 WASHINGTON AVE
BATON ROUGE, LA
70802-2178

Practice Phone: 225-778-7876
Practice Fax: 225-341-6825

Directions to “INNERCORE MANAGEMENT GROUP ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.