Leticia Provost, L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6027 Issued in LA

Practice address

4440 General Meyer Ave
New Orleans, LA 70131-3529

Phone

(504) 361-6500

Fax

(504) 361-6489

NPI assigned

Apr 13, 2010

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Lei Behavioral Services LLC

  • Community/Behavioral Health Agency
  • Metairie, LA
  • NPI 1770911109
  Medicare reassignment NPD
• Metropolitan Human Services District

  • Community/Behavioral Health Agency
  • New Orleans, LA
  • NPI 1316166036
  NPD (past)

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

{
    "created_epoch": "1271116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271116800000",
    "number": "1144546359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4442 GENERAL MEYER AVENUE",
            "address_2": "SUITE 201",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "70131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4440 GENERAL MEYER AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701313529",
            "telephone_number": "504-361-6500",
            "fax_number": "504-361-6489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROVOST",
        "first_name": "LETICIA",
        "name_prefix": "Ms.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-13",
        "last_updated": "2010-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "6027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Destinee Prout
• Marsha Binns Provall, LCSW
• Daniel Provenzano
• Providence Community Housing
• Gail Jones Provost
• Emily Provosty
• Stacie Marie Provosty, M.A. CCC-SLP
• Amy Victoria Prudhomme, D.O.
• Derrick Pruitt, B.S PSYCHOLOGY
• Kristen Pruitt, D.O.

• Clinical Social Worker in New Orleans, LA
• Providers in New Orleans, LA by specialty
• Clinical Social Worker in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.