Active NPI
Ann Carlin Dettman, SSP, LSSP
- School Psychologist
- Metairie, LA
National Provider Identifier
1053060871
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- LSSP018
- Practice address
- 327 Aris Ave
Metairie, LA 70005-3426 - Phone
- (504) 909-1297
- NPI assigned
- Mar 20, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 72142 | TX | |
| School Psychologist | 103TS0200X | LSSP018 | LA | Primary |
Addresses
Primary practice location
327 Aris Ave
Metairie, LA 70005-3426
Mailing address
1800 Ellerslie Ave
La Place, LA 70068-2708
Phone (504) 909-1297
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LSSP018 | LA | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1647734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647734400000",
"number": "1053060871",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1800 ELLERSLIE AVE",
"city": "LA PLACE",
"state": "LA",
"postal_code": "700682708",
"telephone_number": "504-909-1297"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "327 ARIS AVE",
"city": "METAIRIE",
"state": "LA",
"postal_code": "700053426",
"telephone_number": "504-909-1297"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DETTMAN",
"first_name": "ANN",
"middle_name": "CARLIN",
"credential": "SSP, LSSP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-03-20",
"last_updated": "2022-03-20",
"certification_date": "2022-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "TX",
"license": "72142",
"primary": false
},
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "LA",
"license": "LSSP018",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Metairie, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.