Provider Demographics
NPI:1508925942
Name:DARTEZ, ANN M (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ANN
Middle Name:M
Last Name:DARTEZ
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 1:3080 TEDDY DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-1925
Mailing Address - Country:US
Mailing Address - Phone:225-928-0025
Mailing Address - Fax:225-928-0025
Practice Address - Street 1:3080 TEDDY DR
Practice Address - Street 2:SUITE A
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-1925
Practice Address - Country:US
Practice Address - Phone:225-928-0025
Practice Address - Fax:225-928-0025
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA40951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAG3127OtherBLUE CROSS BLUE SHIELD
LAG3127OtherBLUE CROSS BLUE SHIELD