NPIMap

Organization Active NPI

Theresa M Ivey LLC

  • Clinical Social Worker
  • Lake Charles, LA
National Provider Identifier
1285137968
Registry record updated Mar 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
11372 Issued in LA
Legal business name
THERESA M IVEY LLC
Practice address
133 Jefferson Dr
Lake Charles, LA 70605-5713
Phone
(337) 377-3011
NPI assigned
Mar 9, 2018
Last updated
Mar 9, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2018

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

Authorized official

Name
Theresa Ivey, LCSW
Title
Owner
Phone
(337) 377-3011

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 11372 LA Primary

Addresses

Primary practice location

133 Jefferson Dr
Lake Charles, LA 70605-5713

Mailing address

133 Jefferson Dr
Lake Charles, LA 70605-5713
Phone (337) 377-3011

National Provider Directory

National Provider Directory

Locations

133 Jefferson Dr
Bldg H
Lake Charles, LA 70605
Phone (337) 376-0136

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1520553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1520553600000",
    "number": "1285137968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 JEFFERSON DR",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706055713",
            "telephone_number": "337-377-3011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 JEFFERSON DR",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706055713",
            "telephone_number": "337-377-3011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERESA M IVEY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-09",
        "last_updated": "2018-03-09",
        "status": "A",
        "authorized_official_last_name": "IVEY",
        "authorized_official_first_name": "THERESA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "337-377-3011",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "11372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2018; 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.