Provider Demographics
NPI:1467895334
Name:MARY ALICE FUHRER, MSW, LCSW, LLC
Entity Type:Organization
Organization Name:MARY ALICE FUHRER, MSW, LCSW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY ALICE
Authorized Official - Middle Name:
Authorized Official - Last Name:FUHRER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:985-714-4413
Mailing Address - Street 1:510 TOURNAMENT BLVD
Mailing Address - Street 2:
Mailing Address - City:BERWICK
Mailing Address - State:LA
Mailing Address - Zip Code:70342-2050
Mailing Address - Country:US
Mailing Address - Phone:985-714-4413
Mailing Address - Fax:
Practice Address - Street 1:1025 N VICTOR II BLVD
Practice Address - Street 2:
Practice Address - City:MORGAN CITY
Practice Address - State:LA
Practice Address - Zip Code:70380-1349
Practice Address - Country:US
Practice Address - Phone:985-714-4413
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-10
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA89191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty