Individual provider Active NPI

Bonnie Ahn, PHD

  • Clinical Social Worker
  • Baton Rouge, LA
National Provider Identifier
1316459563
Registry record updated Oct 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6904 Issued in LA
Practice address
3973 Choctaw Dr
Baton Rouge, LA 70805-6722
Phone
(225) 361-0507
Fax
(225) 361-0363
NPI assigned
Oct 27, 2017
Last updated
Oct 27, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6904 LA Primary

Addresses

Primary practice location

3973 Choctaw Dr
Baton Rouge, LA 70805-6722

Mailing address

3973 Choctaw Dr
Baton Rouge, LA 70805-6722
Phone (225) 361-0507

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
6904LAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Arc of Safety Outreach Community Development, Inc. Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1509062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509062400000",
    "number": "1316459563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3973 CHOCTAW DR",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708056722",
            "telephone_number": "225-361-0507",
            "fax_number": "225-361-0363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3973 CHOCTAW DR",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708056722",
            "telephone_number": "225-361-0507",
            "fax_number": "225-361-0363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHN",
        "first_name": "BONNIE",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-27",
        "last_updated": "2017-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "6904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 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.

Verify at the official NPI Registry.