Individual ProviderMarilyn Marie FonsecaSocial WorkerBehavioral Health & Social Service ProvidersPractice Address103 Rue Beauregard, Suite B, Lafayette, LA 70508(337) 278-4190(337) 278-4290PECOS EnrollmentBased on the most recent information from CMS, provider Marilyn Marie Fonseca does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1801237128Provider TypeIndividualFull NameFonseca, Marilyn MarieCredentialMSWGenderFemaleSole ProprietorYesEnumeration Date7/15/2013Last Updated7/15/2013Contact InformationPractice LocationPractice Address103 Rue Beauregard, Suite B, Lafayette, LA 70508Phone(337) 278-4190FaxUnlisted FaxMailing LocationMailing Address121 Tanya St, Lafayette, LA 70507-4825Phone(337) 278-4290FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense2148LouisianaCode104100000XDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense2148Louisiana