Organization
C A KONIKOFF MSW LCSW LLC
Active
Organization
C A KONIKOFF MSW LCSW LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CONSTANCE ANNE KONIKOFF MSW LCSW (OWNER)
(337) 981-2110
Entity
Organization
Contact information
Practice address
143 RIDGEWAY DR STE 207, LAFAYETTE, LA 70503-3532
(337) 981-2110
Mailing address
143 RIDGEWAY DR STE 207, LAFAYETTE, LA 70503-3532
(337) 981-2110
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
12/16/2018
Last updated
12/16/2018
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