Individual provider Active NPI

Kyla Anetra Thomas, LCSW-BACS

  • Clinical Social Worker
  • Kenner, LA
National Provider Identifier
1558079616
Registry record updated Nov 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
9397 Issued in LA
Practice address
3800 Grandlake Blvd Apt G204
Kenner, LA 70065-1677
Phone
(504) 451-6788
NPI assigned
Nov 8, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2022

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 9397 LA Primary

Addresses

Primary practice location

3800 Grandlake Blvd Apt G204
Kenner, LA 70065-1677

Mailing address

3800 Grandlake Blvd Apt G204
Kenner, LA 70065-1677
Phone (504) 451-6788

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
I20230711004237 LA Practitioner - Clinical Social Worker 7416316294 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ochsner Clinic LLC Current Accepting new patients
Ochsner Clinic LLC CurrentSince Jun 26, 2023 Accepting new patients
Ochsner Clinic LLC CurrentSince Jun 26, 2023 Accepting new patients

Locations

1514 Jefferson Hwy
New Orleans, LA 70121

Organizations & group practices 3

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": "1667865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667865600000",
    "number": "1558079616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 GRANDLAKE BLVD APT G204",
            "city": "KENNER",
            "state": "LA",
            "postal_code": "700651677",
            "telephone_number": "504-451-6788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 GRANDLAKE BLVD APT G204",
            "city": "KENNER",
            "state": "LA",
            "postal_code": "700651677",
            "telephone_number": "504-451-6788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "KYLA",
        "middle_name": "ANETRA",
        "credential": "LCSW-BACS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-08",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "9397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenner, LA

Sources for this page

Verify at the official NPI Registry.