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NPI Code Detail

MEDICARE: MRS. ELIZABETH CHERYL NOLEN M.S.W. , L.C.S.W.

MEDICARE:  MRS. ELIZABETH CHERYL NOLEN  M.S.W. , L.C.S.W.
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 Worker7370LA

General Provider Information

NPI Number : 1992800965
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ELIZABETH CHERYL NOLEN M.S.W. , L.C.S.W.
Provider Business Mailing Address
First Line : 5319 HALL ST
Second Line :
City : ALEXANDRIA
State : LA
Zip : 71303-4026
Country : US
Telephone Number : 337-531-2629
Fax Number :
Provider Business Practice Location Address
First Line : 1591 BELL RICHARD AVE
Second Line : BUILDING 920
City : FORT POLK
State : LA
Zip : 71459-5405
Country : US
Telephone Number : 337-531-2629
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2006
Last Update Date : 07/08/2007

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