Individual provider Active NPI

Ruth C Caldwell, LCSW

  • Social Worker
  • Shreveport, LA
National Provider Identifier
1295359255
Registry record updated Apr 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
14911 Issued in LA
Practice address
1310 N Hearne, Ave
Shreveport, LA 71107-7904
Phone
(318) 676-5111
Fax
(318) 676-5944
NPI assigned
Jun 4, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Social Worker 104100000X 14911 LA Primary

Addresses

Primary practice location

1310 N Hearne, Ave
Shreveport, LA 71107-7904

Mailing address

1310 N Hearne, Ave
Shreveport, LA 71107-7904
Phone (318) 676-5111

Other practice location 1

2020 E 70th St Ste 301
Shreveport, LA 71105-5332
Phone (318) 553-5591

Other identifiers 1

IdentifierTypeStateIssuer
3240963MedicaidLA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230911003532 LA Practitioner - Clinical Social Worker 9133583024 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jacquelyn Kirby Counseling and Consulting LLCGroup PAC ID 5395001796, 4 clinicians

Practice addresses (Care Compare)

2020 E 70TH St
Suite 110
Shreveport, LA 71105-5332
Phone (318) 553-5591

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14911LAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Jacquelyn Kirby Counseling & Consulting, LLC CurrentSince Apr 26, 2024 Accepting new patients

Locations

2020 E 70th St
Ste 110
Shreveport, LA 71105
Phone (318) 553-5591

2020 E 70th St
Ste 301
Shreveport, LA 71105
Phone (318) 553-5591

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1591228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714089600000",
    "number": "1295359255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 N HEARNE, AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711077904",
            "telephone_number": "318-676-5111",
            "fax_number": "318-676-5944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 N HEARNE, AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711077904",
            "telephone_number": "318-676-5111",
            "fax_number": "318-676-5944"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2020 E 70th St Ste 301",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711055332",
            "country_code": "US",
            "telephone_number": "318-553-5591",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CALDWELL",
        "first_name": "RUTH",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-04",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "LA",
            "license": "14911",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3240963",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.