Susan G Herrod, LCSW

Individual provider Active NPI Clinical Social Worker · Clinton, LA

NPI 1154470425 · NPPES record last updated Mar 25, 2019

Key facts

NPI
1154470425
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
2902 (LA)
Practice address
29437 Highway 63 Ste.14
Clinton, LA 70722
Phone
(225) 683-5292
Fax
(225) 683-1310
NPI assigned
Jan 9, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 2902 LA
Clinical Social Worker 1041C0700X 2902 LA Yes

Addresses

Primary practice location

29437 Highway 63 Ste.14
Clinton, LA 70722

Mailing address

6161 Perkins Rd Ste 2C
Baton Rouge, LA 70808-4119
Phone (225) 769-2770

Other practice location 1

6161 Perkins Rd Ste 2C
Baton Rouge, LA 70808-4119
Phone (225) 769-2770

Other identifiers

IdentifierTypeStateIssuer
2171569MedicaidLA

Other providers in Clinton, LA

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

Sources for this page

Verify at the official NPI Registry.