| Tjbg Inc | |
|
800 Kaliste Saloom Rd Lafayette LA 70508 | |
| (337) 233-2400 | |
| (337) 232-3656 |
| Full Name | Tjbg Inc |
|---|---|
| Speciality | Social Worker |
| Location | 800 Kaliste Saloom Rd, Lafayette, Louisiana |
| Authorized Official Name and Position | Jeana C Sonnier (CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 3372332400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tjbg Inc 800 Kaliste Saloom Rd Lafayette LA 70508 Ph: (337) 233-2400 | Tjbg Inc 800 Kaliste Saloom Rd Lafayette LA 70508 Ph: (337) 233-2400 |
| NPI Number | 1154446268 |
|---|---|
| Provider Enumeration Date | 03/20/2007 |
| Last Update Date | 10/26/2007 |
| Medicare PECOS PAC ID | 9436125515 |
|---|---|
| Medicare Enrollment ID | O20040909000667 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154446268 | NPI | - | NPPES |
| 1456993 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | 939 (Louisiana) | Secondary |
| 1041C0700X | Social Worker - Clinical | 3635 (Louisiana) | Primary |
| Provider Name | Jeana C Sonnier |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427252220 PECOS PAC ID: 1052387180 Enrollment ID: I20040909000334 |
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