Provider Demographics
NPI:1891905402
Name:MAJOR, EDMOND JR (MSW)
Entity Type:Individual
Prefix:MR
First Name:EDMOND
Middle Name:
Last Name:MAJOR
Suffix:JR
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2473 DAGGETT AVE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-2208
Mailing Address - Country:US
Mailing Address - Phone:225-383-2322
Mailing Address - Fax:
Practice Address - Street 1:2473 DAGGETT AVE
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-2208
Practice Address - Country:US
Practice Address - Phone:225-383-2322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA10571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical