Provider Demographics
NPI:1326390907
Name:ORTEGO-ST.GERMAINE, JANIE MARIE (LMSW)
Entity Type:Individual
Prefix:
First Name:JANIE
Middle Name:MARIE
Last Name:ORTEGO-ST.GERMAINE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:JANIE
Other - Middle Name:MARIE
Other - Last Name:ORTEGO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW
Mailing Address - Street 1:PO BOX 471
Mailing Address - Street 2:
Mailing Address - City:THIBODAUX
Mailing Address - State:LA
Mailing Address - Zip Code:70302-0471
Mailing Address - Country:US
Mailing Address - Phone:985-447-8181
Mailing Address - Fax:
Practice Address - Street 1:110 BOWIE RD
Practice Address - Street 2:
Practice Address - City:THIBODAUX
Practice Address - State:LA
Practice Address - Zip Code:70301-6703
Practice Address - Country:US
Practice Address - Phone:985-447-8181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-08
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
LA134401041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
No171M00000XOther Service ProvidersCase Manager/Care Coordinator