Individual
JOHN STANLEY TALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
420 AVENUE F, BOGALUSA, LA 70427-3600
(985) 732-0058
(985) 732-0019
Mailing address
5959 S SHERWOOD FOREST BLVD, BATON ROUGE, LA 70816-6038
(225) 526-0001
(225) 765-9196
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
4008
LA
1041C0700X
Clinical Social Worker
Primary
4008
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4008
SOCIAL WORK EXAMINERS LICENSE
LA
Enumeration date
06/09/2008
Last updated
07/21/2022
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