Provider Demographics
NPI:1639692049
Name:MAYER, CAROLINE JEANETTE
Entity Type:Individual
Prefix:MS
First Name:CAROLINE
Middle Name:JEANETTE
Last Name:MAYER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CAROLINE
Other - Middle Name:JEANETTE
Other - Last Name:MAYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MHS
Mailing Address - Street 1:3600 JACKSON ST STE 119
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71303-3096
Mailing Address - Country:US
Mailing Address - Phone:318-625-7050
Mailing Address - Fax:
Practice Address - Street 1:3600 JACKSON STREET SUITE 119
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71303-3673
Practice Address - Country:US
Practice Address - Phone:318-625-7050
Practice Address - Fax:318-704-6201
Is Sole Proprietor?:No
Enumeration Date:2017-07-18
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator