Provider Demographics
NPI:1144566142
Name:MCNEMAR, KRYSTAL FISHER (LCSW)
Entity Type:Individual
Prefix:
First Name:KRYSTAL
Middle Name:FISHER
Last Name:MCNEMAR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2158
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70502-2158
Mailing Address - Country:US
Mailing Address - Phone:337-521-7093
Mailing Address - Fax:
Practice Address - Street 1:315 RUE DU BELIER
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-4813
Practice Address - Country:US
Practice Address - Phone:337-521-7093
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-19
Last Update Date:2012-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA66991041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool