Provider Demographics
NPI:1295115541
Name:SOCIAL WORK CONSULTANT SERVICES
Entity type:Organization
Organization Name:SOCIAL WORK CONSULTANT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:LOUISE
Authorized Official - Middle Name:
Authorized Official - Last Name:LOADHOLT
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:917-783-1406
Mailing Address - Street 1:420 MARKLEN LOOP
Mailing Address - Street 2:
Mailing Address - City:POLK CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33868-9035
Mailing Address - Country:US
Mailing Address - Phone:917-783-1406
Mailing Address - Fax:
Practice Address - Street 1:420 MARKLEN LOOP
Practice Address - Street 2:
Practice Address - City:POLK CITY
Practice Address - State:FL
Practice Address - Zip Code:33868-9035
Practice Address - Country:US
Practice Address - Phone:917-783-1406
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-02
Last Update Date:2015-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health