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Organization

GINO BERTUCCI, LCSW LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. GINO JOSEPH BERTUCCI LCSW (OWNER)
(225) 938-9971
Entity
Organization

Contact information

Practice address
7341 JEFFERSON HWY, STE E, BATON ROUGE, LA 70806-8203
(225) 938-9971
Mailing address
PO BOX 2731, SAINT FRANCISVILLE, LA 70775-2731
(225) 938-9971
(225) 635-6907

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4092
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1568638260
INDIVIDUAL NPI
LA
Enumeration date
03/08/2012
Last updated
03/09/2012
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