Provider Demographics
NPI:1255543534
Name:BAYARD, TAMMY (MSW)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:
Last Name:BAYARD
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 WHITNEY AVE
Mailing Address - Street 2:SUITE 605A
Mailing Address - City:GRETNA
Mailing Address - State:LA
Mailing Address - Zip Code:70056-2558
Mailing Address - Country:US
Mailing Address - Phone:504-616-9036
Mailing Address - Fax:504-309-7845
Practice Address - Street 1:401 WHITNEY AVE
Practice Address - Street 2:SUITE 605A
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70056-2558
Practice Address - Country:US
Practice Address - Phone:504-616-9036
Practice Address - Fax:504-309-7845
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2009-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA29921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5S873Medicare UPIN