Active NPI
Amy Nicole Dysart, LCSW
- Clinical Social Worker
- Rayne, LA
National Provider Identifier
1598050262
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 9020
- Practice address
- 908 Louisa Ave
Rayne, LA 70578-7230 - Phone
- (225) 270-0100
- NPI assigned
- Jun 10, 2011
- Last updated
- Dec 6, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 9020 | LA | Primary |
Addresses
Primary practice location
908 Louisa Ave
Rayne, LA 70578-7230
Mailing address
908 Louisa Ave
Rayne, LA 70578-7230
Phone (225) 270-0100
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9020 | LA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mental Health Management, LLC | Past | Accepting new patients |
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.
-
- Social Worker
- Lafayette, LA
- NPI 1679869812
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1307664000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323129600000",
"number": "1598050262",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "908 LOUISA AVE",
"city": "RAYNE",
"state": "LA",
"postal_code": "705787230",
"telephone_number": "225-270-0100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "908 LOUISA AVE",
"city": "RAYNE",
"state": "LA",
"postal_code": "705787230",
"telephone_number": "225-270-0100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DYSART",
"first_name": "AMY",
"middle_name": "NICOLE",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-06-10",
"last_updated": "2011-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "LA",
"license": "9020",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rayne, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.