Individual provider Active NPI

Loretta Gail Braudaway, L.C.S.W.

  • Clinical Social Worker
  • Natchitoches, LA
National Provider Identifier
1053466896
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2390 Issued in LA
Practice address
1533 Salter St
Natchitoches, LA 71457-5231
Phone
(318) 357-3122
Fax
(318) 357-3240
NPI assigned
Jan 24, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 2390 LA Primary

Addresses

Primary practice location

1533 Salter St
Natchitoches, LA 71457-5231

Mailing address

1533 Salter St
Natchitoches, LA 71457-5231
Phone (318) 357-3122

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

LicenseStateTypeSpecialty
2390LAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053466896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1533 SALTER ST",
            "city": "NATCHITOCHES",
            "state": "LA",
            "postal_code": "714575231",
            "telephone_number": "318-357-3122",
            "fax_number": "318-357-3240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1533 SALTER ST",
            "city": "NATCHITOCHES",
            "state": "LA",
            "postal_code": "714575231",
            "telephone_number": "318-357-3122",
            "fax_number": "318-357-3240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAUDAWAY",
        "first_name": "LORETTA",
        "middle_name": "GAIL",
        "name_prefix": "Mrs.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "2390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Natchitoches, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.