Kiley P Cedotal, LCSW-BACS, FACHE

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6181 Issued in LA

Practice address

532 Ponderosa Dr
Ponchatoula, LA 70454-9428

Phone

(225) 715-8768

NPI assigned

Jan 22, 2025

Sex

Male

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

Specialty

Clinical Social Worker

Education

Other, 1999

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  LA

  Medicare reassignment
• Icon Hospital, LLP

  • General Acute Care Hospital
  • Humble, TX
  • NPI 1598948150
  NPD (past)

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

{
    "created_epoch": "1737504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1194537597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "532 PONDEROSA DR",
            "city": "PONCHATOULA",
            "state": "LA",
            "postal_code": "704549428",
            "telephone_number": "225-715-8768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "532 PONDEROSA DR",
            "city": "PONCHATOULA",
            "state": "LA",
            "postal_code": "704549428",
            "telephone_number": "225-715-8768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CEDOTAL",
        "first_name": "KILEY",
        "middle_name": "P",
        "credential": "LCSW-BACS, FACHE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-01-22",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "6181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela Ann Camp, RN, CCM
• Meagan Lindsey Canville, SLP
• Caring Heart Couseling Center, LLC
• Karen L Carter, DC
• Brittany Causey
• Central Home Health of Metairie LLC
• Carol Lynne Charrier, PHARM D
• Katherine M Chauvin, RN, RD, LDN
• Kenita Chenevert, CLC
• Jerwanna Collier Clay, LCSW

• Clinical Social Worker in Ponchatoula, LA
• Providers in Ponchatoula, 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 Jan 22, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.