Basic Information
| Provider Information | |||||||||
| NPI: | 1255715546 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LACARRIERE | ||||||||
| FirstName: | JENNIFER | ||||||||
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| Credential: | LMSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 66156 | ||||||||
| Address2: | |||||||||
| City: | BATON ROUGE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 708966156 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2256502000 | ||||||||
| FaxNumber: | 2256158212 | ||||||||
| Practice Location | |||||||||
| Address1: | 3140 FLORIDA BLVD | ||||||||
| Address2: | |||||||||
| City: | BATON ROUGE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 708063757 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2256502000 | ||||||||
| FaxNumber: | 2256502099 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/16/2015 | ||||||||
| LastUpdateDate: | 10/18/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 0952901 | NY | N | Behavioral Health & Social Service Providers | Social Worker | 104100000X | 14040 | LA | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.