Active NPI
Patricia Aline Wyles, LCSW, LLC
- Clinical Social Worker
- Greenwell Springs, LA
National Provider Identifier
1295160828
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 10232
- Practice address
- 17620 Villa Trace Ave
Greenwell Springs, LA 70739-4648 - Phone
- (225) 270-5742
- Fax
- (225) 664-0760
- NPI assigned
- Sep 13, 2013
- Last updated
- Mar 30, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 10232 | LA | Primary |
Addresses
Primary practice location
17620 Villa Trace Ave
Greenwell Springs, LA 70739-4648
Mailing address
17620 Villa Trace Ave
Greenwell Springs, LA 70739-4648
Phone (225) 270-5742
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10232 | LA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1379030400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1490832000000",
"number": "1295160828",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17620 VILLA TRACE AVE",
"city": "GREENWELL SPRINGS",
"state": "LA",
"postal_code": "707394648",
"telephone_number": "225-270-5742",
"fax_number": "225-664-0760"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17620 VILLA TRACE AVE",
"city": "GREENWELL SPRINGS",
"state": "LA",
"postal_code": "707394648",
"telephone_number": "225-270-5742",
"fax_number": "225-664-0760"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WYLES",
"first_name": "PATRICIA",
"middle_name": "ALINE",
"credential": "LCSW, LLC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-09-13",
"last_updated": "2017-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "LA",
"license": "10232",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenwell Springs, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.