Individual provider Active NPI

Angela White, LCSW BACS

  • Clinical Social Worker
  • Shreveport, LA
National Provider Identifier
1558713438
Registry record updated Apr 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
11839 Issued in LA
Practice address
7330 Fern Ave Ste 204
Shreveport, LA 71105-4973
Phone
(318) 216-3239
Fax
(318) 368-1155
NPI assigned
Jul 5, 2016
Last updated
Apr 21, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2024

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 11839 LA Primary

Addresses

Primary practice location

7330 Fern Ave Ste 204
Shreveport, LA 71105-4973

Mailing address

9315 Midvale Dr
Shreveport, LA 71118-3554
Phone (318) 751-0802

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
I20220607003167 LA Practitioner - Clinical Social Worker 4385022193 Practice locations: Shreveport, LA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Angela B. White, LCSW Bacs Clinical CurrentSince Apr 20, 2022 Accepting new patients

Locations

7330 Fern Ave
Ste 204
Shreveport, LA 71105
Phone (318) 216-3239

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": "1467676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713657600000",
    "number": "1558713438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9315 MIDVALE DR",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711183554",
            "telephone_number": "318-751-0802",
            "fax_number": "318-751-0802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7330 FERN AVE STE 204",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711054973",
            "telephone_number": "318-216-3239",
            "fax_number": "318-368-1155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "ANGELA",
        "credential": "LCSW BACS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-05",
        "last_updated": "2024-04-21",
        "certification_date": "2024-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "11839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.