| Ann Lavergne, Lcsw, Llc | |
|
215 Rue Fontaine Lafayette LA 70508-5742 | |
| (337) 945-3678 | |
| Not Available |
| Full Name | Ann Lavergne, Lcsw, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 215 Rue Fontaine, Lafayette, Louisiana |
| Authorized Official Name and Position | Ann Lavergne (OWNER) |
| Authorized Official Contact | 3379453678 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ann Lavergne, Lcsw, Llc Po Box 583 Church Point LA 70525-0583 Ph: (337) 945-3678 | Ann Lavergne, Lcsw, Llc 215 Rue Fontaine Lafayette LA 70508-5742 Ph: (337) 945-3678 |
| NPI Number | 1740866169 |
|---|---|
| Provider Enumeration Date | 03/24/2021 |
| Last Update Date | 03/24/2021 |
| Certification Date | 03/24/2021 |
| Medicare PECOS PAC ID | 3476960527 |
|---|---|
| Medicare Enrollment ID | O20210407002649 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740866169 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Ann Lavergne |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891370219 PECOS PAC ID: 2365859410 Enrollment ID: I20210407002835 |
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