Basic Information
Provider Information
NPI: 1740799642
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ARMAND
FirstName: DOROTHY
MiddleName: CARY
NamePrefix:  
NameSuffix:  
Credential: LCSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6827 KENNON ST
Address2:  
City: SHREVEPORT
State: LA
PostalCode: 711197519
CountryCode: US
TelephoneNumber: 3186218676
FaxNumber:  
Practice Location
Address1: 1310 N HEARNE AVE
Address2:  
City: SHREVEPORT
State: LA
PostalCode: 71107
CountryCode: US
TelephoneNumber: 3186765111
FaxNumber: 3186765137
Other Information
ProviderEnumerationDate: 09/22/2017
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700X3905LAY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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