Individual provider Active NPI

Chantel Crockett, LCSW

  • Clinical Social Worker
  • Baton Rouge, LA
National Provider Identifier
1114431863
Registry record updated Nov 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
15883 Issued in LA
Practice address
2351 Energy Dr Ste 1100
Baton Rouge, LA 70808-2617
Phone
(225) 465-3080
Fax
(225) 465-3706
NPI assigned
Nov 16, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2024

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 15883 LA Primary

Addresses

Primary practice location

2351 Energy Dr Ste 1100
Baton Rouge, LA 70808-2617

Mailing address

2376 Creek Hollow Ave
Zachary, LA 70791-2895
Phone (225) 218-7472

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
15883LAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Red Stick Counseling Services, LLC CurrentSince Sep 25, 2019 Accepting new patients
Priority Care Case Management CurrentSince Jan 12, 2025 Accepting new patients

Locations

2351 Energy Dr
Ste 1100
Baton Rouge, LA 70808
Phone (225) 465-3080

530 Lakeland Dr
Ste 2B
Baton Rouge, LA 70802
Phone (225) 218-7472

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1510790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732147200000",
    "number": "1114431863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2376 CREEK HOLLOW AVE",
            "city": "ZACHARY",
            "state": "LA",
            "postal_code": "707912895",
            "telephone_number": "225-218-7472",
            "fax_number": "225-465-3706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2351 ENERGY DR STE 1100",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708082617",
            "telephone_number": "225-465-3080",
            "fax_number": "225-465-3706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROCKETT",
        "first_name": "CHANTEL",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-16",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "15883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2024; 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.