Active NPI
Rachel Davis, LCSW, CCS, LAC
- Clinical Social Worker
- Amite, LA
National Provider Identifier
1619149382
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 8468
- Practice address
- 411 E Mulberry St
Amite, LA 70422-2527 - Phone
- (225) 252-2212
- Fax
- (225) 751-6302
- NPI assigned
- Apr 2, 2008
- Last updated
- Oct 29, 2013
- Sex
- Female
- Sole proprietor
- No
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 | 8468 | LA | Primary |
Addresses
Primary practice location
411 E Mulberry St
Amite, LA 70422-2527
Mailing address
5524 S Afton Pkwy
Baton Rouge, LA 70806-3542
Phone (225) 252-2212
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1009 | Other | LA | LAC |
| 111 | Other | LA | CERTIFIED CLINICAL SUPERVISOR |
| 600551753 | Medicaid | LA | |
| 8468 | Other | LA | GSW |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8468 | LA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Changing Matters | Clinical | 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.
-
- Clinical Social Worker
- Amite, LA
- NPI 1356771232
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1207094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383004800000",
"number": "1619149382",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5524 S AFTON PKWY",
"city": "BATON ROUGE",
"state": "LA",
"postal_code": "708063542",
"telephone_number": "225-252-2212",
"fax_number": "225-751-6302"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "411 E MULBERRY ST",
"city": "AMITE",
"state": "LA",
"postal_code": "704222527",
"telephone_number": "225-252-2212",
"fax_number": "225-751-6302"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "RACHEL",
"credential": "LCSW, CCS, LAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-02",
"last_updated": "2013-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "LA",
"license": "8468",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LAC",
"identifier": "1009",
"state": "LA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CERTIFIED CLINICAL SUPERVISOR",
"identifier": "111",
"state": "LA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "600551753",
"state": "LA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GSW",
"identifier": "8468",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Amite, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.