| Elizabeth Moore Standifer, Lcsw Llc | |
|
4358 S Jeffrey Dr Ste A Baton Rouge LA 70816-4196 | |
| (225) 441-0139 | |
| Not Available |
| Full Name | Elizabeth Moore Standifer, Lcsw Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4358 S Jeffrey Dr Ste A, Baton Rouge, Louisiana |
| Authorized Official Name and Position | Elizabeth Moore Standifer (OWNER/MANAGER) |
| Authorized Official Contact | 2254410139 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elizabeth Moore Standifer, Lcsw Llc Po Box 41151 Baton Rouge LA 70835-1151 Ph: () - | Elizabeth Moore Standifer, Lcsw Llc 4358 S Jeffrey Dr Ste A Baton Rouge LA 70816-4196 Ph: (225) 441-0139 |
| NPI Number | 1609593128 |
|---|---|
| Provider Enumeration Date | 10/25/2022 |
| Last Update Date | 09/17/2023 |
| Certification Date | 09/17/2023 |
| Medicare PECOS PAC ID | 7315310042 |
|---|---|
| Medicare Enrollment ID | O20230228002552 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609593128 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Elizabeth Standifer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942547245 PECOS PAC ID: 2860710555 Enrollment ID: I20150408002652 |
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