Active NPI
Lydie Mary Phillips, LCSW, RN
- Clinical Social Worker
- Jefferson, LA
National Provider Identifier
1013377852
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 7372
- Practice address
- 229 Jules Ave
Jefferson, LA 70121-2820 - Phone
- (504) 628-8730
- NPI assigned
- Mar 4, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 7372 | LA | Primary |
Addresses
Primary practice location
229 Jules Ave
Jefferson, LA 70121-2820
Mailing address
229 Jules Ave
Jefferson, LA 70121-2820
Phone (504) 628-8730
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7372 | LA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1457049600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1457049600000",
"number": "1013377852",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "229 JULES AVE",
"city": "JEFFERSON",
"state": "LA",
"postal_code": "701212820",
"telephone_number": "504-628-8730"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "229 JULES AVE",
"city": "JEFFERSON",
"state": "LA",
"postal_code": "701212820",
"telephone_number": "504-628-8730"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "LYDIE",
"middle_name": "MARY",
"credential": "LCSW, RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-03-04",
"last_updated": "2016-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "LA",
"license": "7372",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jefferson, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.