Individual provider Active NPI

Mayra Janet Huerstel, LCSW

  • Clinical Social Worker
  • Slidell, LA
National Provider Identifier
1407977051
Registry record updated Aug 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
14071 Issued in LA
Practice address
501 Robert Blvd
Slidell, LA 70458
Phone
(985) 307-1600
Fax
(504) 575-3691
NPI assigned
Apr 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 27677 CA
Clinical Social Worker 1041C0700X 14071 LA Primary

Addresses

Primary practice location

501 Robert Blvd
Slidell, LA 70458

Mailing address

2900 Indiana Ave
Kenner, LA 70065-4605
Phone (504) 575-3712

Other names 1

  • Mayra J Villareal Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20150122002579 CA Practitioner - Clinical Social Worker 4981928900 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14071LAMDClinical Social Worker
27677CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Foothill Family Service - Hudson CurrentSince Dec 1, 2014 Accepting new patients
Foothill Family Service CurrentSince Dec 1, 2014 Accepting new patients
Access Health Louisiana Past Accepting new patients
Access Health Louisiana Clinical Past Accepting new patients

Locations

2500 E Foothill Blvd
Ste 300
Pasadena, CA 91107
Phone (626) 564-1613

Interoperability endpoints

  • Direct secure messaging: mayra.huerstel.1@11331.direct.athenahealth.com

Organizations & group practices 4

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": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534204800000",
    "number": "1407977051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 INDIANA AVE",
            "city": "KENNER",
            "state": "LA",
            "postal_code": "700654605",
            "telephone_number": "504-575-3712",
            "fax_number": "504-575-3691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 ROBERT BLVD",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "70458",
            "telephone_number": "985-307-1600",
            "fax_number": "504-575-3691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUERSTEL",
        "first_name": "MAYRA",
        "middle_name": "JANET",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-02",
        "last_updated": "2018-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "27677",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "14071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAYRA",
            "last_name": "VILLAREAL",
            "middle_name": "J",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Slidell, LA

Sources for this page

Verify at the official NPI Registry.