| C A Konikoff Msw Lcsw Llc | |
|
143 Ridgeway Dr Ste 207 Lafayette LA 70503-3532 | |
| (337) 981-2110 | |
| Not Available |
| Full Name | C A Konikoff Msw Lcsw Llc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 143 Ridgeway Dr Ste 207, Lafayette, Louisiana |
| Authorized Official Name and Position | Constance Anne Konikoff (OWNER) |
| Authorized Official Contact | 3379812110 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| C A Konikoff Msw Lcsw Llc 143 Ridgeway Dr Ste 207 Lafayette LA 70503-3532 Ph: (337) 981-2110 | C A Konikoff Msw Lcsw Llc 143 Ridgeway Dr Ste 207 Lafayette LA 70503-3532 Ph: (337) 981-2110 |
| NPI Number | 1659842789 |
|---|---|
| Provider Enumeration Date | 12/16/2018 |
| Last Update Date | 12/16/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659842789 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Secondary |
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