Individual provider Active NPI

Avis D Lawrence, LCSW

  • Clinical Social Worker
  • Prairieville, LA
National Provider Identifier
1013208404
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
5329 Issued in LA
Practice address
17487 Old Jefferson Hwy Ste a
Prairieville, LA 70769-4043
Phone
(225) 910-2477
Fax
(225) 647-3213
NPI assigned
Apr 20, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 5329 LA Primary

Addresses

Primary practice location

17487 Old Jefferson Hwy Ste a
Prairieville, LA 70769-4043

Mailing address

6486 Highway 44
Gonzales, LA 70737-8158
Phone (225) 910-2477

Other identifiers 1

IdentifierTypeStateIssuer
1013208404MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120723000474 LA Practitioner - Clinical Social Worker 5092716522 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

17487 Old Jefferson Hwy
Suite a
Prairieville, LA 70769-4043
Phone (225) 910-2477

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Counseling Alternatives, LLC CurrentSince Jun 7, 2012 Accepting new patients

Locations

17487 Old Jefferson Hwy
Ste A
Prairieville, LA 70769
Phone (225) 910-2477

17487 Old Jefferson Hwy
Prairieville, LA 70769
Phone (225) 677-7777

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1303257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1013208404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6486 HIGHWAY 44",
            "city": "GONZALES",
            "state": "LA",
            "postal_code": "707378158",
            "telephone_number": "225-910-2477",
            "fax_number": "225-647-3213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17487 OLD JEFFERSON HWY STE A",
            "city": "PRAIRIEVILLE",
            "state": "LA",
            "postal_code": "707694043",
            "telephone_number": "225-910-2477",
            "fax_number": "225-647-3213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWRENCE",
        "first_name": "AVIS",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-20",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "5329",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013208404",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Prairieville, LA

Sources for this page

Verify at the official NPI Registry.