Provider Demographics
NPI:1225401748
Name:GEORGE, NATHAN (LMSW)
Entity Type:Individual
Prefix:
First Name:NATHAN
Middle Name:
Last Name:GEORGE
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19157 CROWLEY EUNICE HWY
Mailing Address - Street 2:
Mailing Address - City:CROWLEY
Mailing Address - State:LA
Mailing Address - Zip Code:70526-0801
Mailing Address - Country:US
Mailing Address - Phone:337-514-2101
Mailing Address - Fax:
Practice Address - Street 1:19157 CROWLEY EUNICE HWY
Practice Address - Street 2:
Practice Address - City:CROWLEY
Practice Address - State:LA
Practice Address - Zip Code:70526-0801
Practice Address - Country:US
Practice Address - Phone:337-514-2101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-05
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
LA127781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor