Mrs Loretta Marie Bouchard, | |
1061 Harmon Ave, Fort Stewart, GA 31314-5604 | |
(912) 315-6430 | |
Not Available |
Full Name | Mrs Loretta Marie Bouchard |
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Gender | Female |
Speciality | Social Worker - Clinical |
Location | 1061 Harmon Ave, Fort Stewart, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1295795128 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | CSW003609 (Georgia) | Primary |
Entity Name | Michael L. Sakowitz Ph.d., P.a, |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1952464984 PECOS PAC ID: 3779536404 Enrollment ID: O20081206000021 |
Mailing Address | Practice Location Address |
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Mrs Loretta Marie Bouchard, 109 Tappan Zee Drive, Pooler, GA 31322 Ph: (912) 330-0056 | Mrs Loretta Marie Bouchard, 1061 Harmon Ave, Fort Stewart, GA 31314-5604 Ph: (912) 315-6430 |
Mr. Ronald James Whalen, MSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: Bldg 920, Fort Stewart, GA 31314 Phone: 912-767-2620 | |
Sean Carley Bell, L.C.S.W. Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1061 Harmon Ave, Fort Stewart, GA 31314 Phone: 912-435-6965 | |
Mr. James Christopher Mcnerney, L.C.S.W. Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1061 Harmon Ave, Ste1d03, Fort Stewart, GA 31314 Phone: 912-767-7301 | |
Robin Galloway, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1061 Harmon Ave, Fort Stewart, GA 31314 Phone: 912-435-6965 | |
Rufus Battle Jr., SOCIAL WORKER Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1061 Harmon Ave, Ste 1d03, Fort Stewart, GA 31314 Phone: 912-435-6633 Fax: 912-435-5966 | |
Ms. Donna Marie Bradshaw Brubaker, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1061 Harmon Ave, Fort Stewart, GA 31314 Phone: 912-435-1342 | |
Karen Ashley, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1061 Harmon Ave, Fort Stewart, GA 31314 Phone: 912-435-6633 |