Provider Demographics
NPI:1982954012
Name:FUHRER, MARY ALICE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MARY ALICE
Middle Name:
Last Name:FUHRER
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 1:1025 N VICTOR II BLVD
Mailing Address - Street 2:SUITE S, ROOM 109
Mailing Address - City:MORGAN CITY
Mailing Address - State:LA
Mailing Address - Zip Code:70380-1349
Mailing Address - Country:US
Mailing Address - Phone:985-714-4413
Mailing Address - Fax:
Practice Address - Street 1:1025 N VICTOR II BLVD
Practice Address - Street 2:SUITE S, ROOM 109
Practice Address - City:MORGAN CITY
Practice Address - State:LA
Practice Address - Zip Code:70380-1349
Practice Address - Country:US
Practice Address - Phone:985-714-4413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-17
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA89191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical