Active NPI
Marsha Binns Provall, LCSW
- Clinical Social Worker
- New Orleans, LA
National Provider Identifier
1669493458
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 3420
- Practice address
- 1111 S Jefferson Davis Pkwy
New Orleans, LA 70125 - Phone
- (504) 486-2650
- NPI assigned
- Jul 21, 2006
- 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 | 3420 | LA | Primary |
Addresses
Primary practice location
1111 S Jefferson Davis Pkwy
New Orleans, LA 70125
Mailing address
1841 Leboeuf CT
A2-206
New Orleans, LA 70114-6177
Phone (504) 367-5500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1463787 | Medicaid | LA |
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 |
|---|---|---|---|
| 3420 | LA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1669493458",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1841 LEBOEUF CT",
"address_2": "A2-206",
"city": "NEW ORLEANS",
"state": "LA",
"postal_code": "701146177",
"telephone_number": "504-367-5500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1111 S JEFFERSON DAVIS PKWY",
"city": "NEW ORLEANS",
"state": "LA",
"postal_code": "70125",
"telephone_number": "504-486-2650"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PROVALL",
"first_name": "MARSHA",
"middle_name": "BINNS",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "LA",
"license": "3420",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1463787",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in New Orleans, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.