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Constance Anne Konikoff

Social Worker

Behavioral Health & Social Service Providers

143 Ridgeway Dr Ste 207, Lafayette, LA 70503-3532

PECOS Enrollment

This provider is enrolled in PECOS as CONSTANCE KONIKOFF.

Based on the most recent information from CMS, provider Constance Anne Konikoff is legally eligible to order and refer claims for Part B and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records today at 10:46 AM.

Profile Details

Provider ID
1164573580
Provider Type
Individual
Full Name
Konikoff, Constance Anne
Title
Ms.
Credential
MSW, LCSW

Gender
Female
Sole Proprietor
No
Enumeration Date
1/13/2007
Last Updated
12/13/2018

Contact Information

Practice Location

143 Ridgeway Dr Ste 207, Lafayette, LA 70503-3532

(337) 258-6125

Unlisted Fax

Mailing Location

143 Ridgeway Dr Ste 207, Lafayette, LA 70503-3532

(337) 258-6125

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 2707 Louisiana

Constance Anne Konikoff

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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