Individual provider Active NPI

Christy Michelle Denicola, LCSW

  • Clinical Social Worker
  • Clinton, LA
National Provider Identifier
1447445622
Registry record updated Mar 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
5502 Issued in LA
Practice address
11990 Jackson St
Clinton, LA 70722-3210
Phone
(225) 683-5292
Fax
(225) 683-1310
NPI assigned
Sep 11, 2007
Last updated
Mar 26, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2019

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 5502 LA Primary

Addresses

Primary practice location

11990 Jackson St
Clinton, LA 70722-3210

Mailing address

PO Box 395
Clinton, LA 70722-0395
Phone (225) 683-5292

Other identifiers 1

IdentifierTypeStateIssuer
1031445MedicaidLA

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
I20080121000118 LA Practitioner - Clinical Social Worker 0042391658 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

11990 Jackson St
Clinton, LA 70722-3210
Phone (225) 683-5292

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Care Providers for a Healthy Feliciana, Inc CurrentSince Dec 15, 2009 Accepting new patients
Primary Care Providers for a Healthy Feliciana, Inc. CurrentSince Dec 15, 2009 Accepting new patients
Primary Care Providers for a Healthy Feliciana, Inc. Past Accepting new patients
Primary Care Providers for a Healthy Feliciana Inc Past Accepting new patients
Primary Care Providers for a Healthy Feliciana, Inc Past Accepting new patients
Primary Care Providers for a Healthy Feliciana, Inc Past Accepting new patients

Locations

455 E Airport Ave
Baton Rouge, LA 70806
Phone (225) 201-0950

10410 Plank Rd
Clinton, LA 70722
Phone (225) 683-8877

11990 Jackson St
Clinton, LA 70722
Phone (225) 570-6111

28315 S Frost Rd
Livingston, LA 70754
Phone (225) 283-1356

54016 Highway 1062
Loranger, LA 70446
Phone (985) 606-9000

3553 Rosedale Rd
Port Allen, LA 70767
Phone (225) 234-0227

Interoperability endpoints

  • Direct secure messaging: christy.denicola.p1@direct.rkmprimarycare.nextgenshare.com

Organizations & group practices 6

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": "1189468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553558400000",
    "number": "1447445622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 395",
            "city": "CLINTON",
            "state": "LA",
            "postal_code": "707220395",
            "telephone_number": "225-683-5292",
            "fax_number": "225-222-6543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11990 JACKSON ST",
            "city": "CLINTON",
            "state": "LA",
            "postal_code": "707223210",
            "telephone_number": "225-683-5292",
            "fax_number": "225-683-1310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENICOLA",
        "first_name": "CHRISTY",
        "middle_name": "MICHELLE",
        "name_prefix": "Miss",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-11",
        "last_updated": "2019-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "5502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1031445",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, LA

Sources for this page

Verify at the official NPI Registry.