Terry Collins Ainsworth, LCSW

Individual provider Active NPI Clinical Social Worker · Ponchatoula, LA

NPI 1144844804 · NPPES record last updated Oct 10, 2022

Key facts

NPI
1144844804
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
6541 (LA)
Practice address
787 N 7TH St Ste a
Ponchatoula, LA 70454-3115
Phone
(985) 974-0429
Fax
(504) 294-8310
NPI assigned
May 28, 2020
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20221020000840 LA Practitioner - Clinical Social Worker 1052787793

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6541 LA Yes

Addresses

Primary practice location

787 N 7TH St Ste a
Ponchatoula, LA 70454-3115

Mailing address

42484 Blyth Ave
Ponchatoula, LA 70454-5498
Phone (985) 974-0429

Other practice location 1

905 S Walnut St
Hammond, LA 70403-4568
Phone (985) 974-0429

Other providers in Ponchatoula, LA

All providers in Ponchatoula, LA · Clinical Social Worker in Louisiana

Sources for this page

Verify at the official NPI Registry.