Provider Demographics
NPI:1659478782
Name:BENGTSSON, NANCY CAROLL (LCSW)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:CAROLL
Last Name:BENGTSSON
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 1:433 METAIRIE RD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70005-4333
Mailing Address - Country:US
Mailing Address - Phone:504-837-8811
Mailing Address - Fax:504-837-8812
Practice Address - Street 1:433 METAIRIE RD
Practice Address - Street 2:SUITE 220
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70005-4333
Practice Address - Country:US
Practice Address - Phone:504-837-8811
Practice Address - Fax:504-837-8812
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2520104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker