Individual provider Active NPI

Pamela Wall, LCSW

  • Clinical Social Worker
  • Saint Francisville, LA
National Provider Identifier
1114299146
Registry record updated Feb 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1291 Issued in LA
Practice address
9794 Bains Road
Saint Francisville, LA 70775
Phone
(225) 635-5299
Fax
(225) 635-3387
NPI assigned
Feb 7, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2012

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 1291 LA Primary

Addresses

Primary practice location

9794 Bains Road
Saint Francisville, LA 70775

Mailing address

PO Box 2820
Saint Francisville, LA 70775-2820
Phone (225) 635-5299

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
1291LAMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
West Feliciana Parish School Board Past Accepting new patients
West Feliciana School Board Past Accepting new patients

Organizations & group practices 2

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": "1328572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328572800000",
    "number": "1114299146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2820",
            "city": "SAINT FRANCISVILLE",
            "state": "LA",
            "postal_code": "707752820",
            "telephone_number": "225-635-5299",
            "fax_number": "225-635-3387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9794 BAINS ROAD",
            "city": "SAINT FRANCISVILLE",
            "state": "LA",
            "postal_code": "70775",
            "telephone_number": "225-635-5299",
            "fax_number": "225-635-3387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALL",
        "first_name": "PAMELA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-07",
        "last_updated": "2012-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "1291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Francisville, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2012; 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.