Individual provider Active NPI

Janice B Manuel, LCSW

  • Clinical Social Worker
  • Lake Charles, LA
National Provider Identifier
1396340030
Registry record updated Dec 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3303 Issued in LA
Practice address
975 Bonnie Blue Ave
Lake Charles, LA 70611-4220
Phone
(337) 661-2775
NPI assigned
Dec 1, 2020
Last updated
Dec 1, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2020

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 3303 LA Primary

Addresses

Primary practice location

975 Bonnie Blue Ave
Lake Charles, LA 70611-4220

Mailing address

975 Bonnie Blue Ave
Lake Charles, LA 70611-4220
Phone (337) 661-2775

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

LicenseStateTypeSpecialty
3303LAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1606780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1396340030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "975 BONNIE BLUE AVE",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706114220",
            "telephone_number": "337-661-2775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 BONNIE BLUE AVE",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706114220",
            "telephone_number": "337-661-2775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANUEL",
        "first_name": "JANICE",
        "middle_name": "B",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-01",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "3303",
            "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 Dec 1, 2020; 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.