Provider Demographics
NPI:1225194368
Name:DANIEL J. LONOWSKI, PH. D., A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:DANIEL J. LONOWSKI, PH. D., A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:LONOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:318-443-2338
Mailing Address - Street 1:4703 BAYOU COURT DR
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71303-2564
Mailing Address - Country:US
Mailing Address - Phone:318-443-2338
Mailing Address - Fax:318-443-0258
Practice Address - Street 1:1605 MURRAY ST
Practice Address - Street 2:SUITE 225
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-6890
Practice Address - Country:US
Practice Address - Phone:318-443-2338
Practice Address - Fax:318-443-0258
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-30
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA299103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA20589OtherBLUE CROSS
LA5DC53Medicare PIN
LA20589OtherBLUE CROSS