Active NPI
Nicole Fontenot, LCSW
- Clinical Social Worker
- Carencro, LA
National Provider Identifier
1689337487
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 14127
- Practice address
- 3423 NW Evangeline Trwy
Carencro, LA 70520-6241 - Phone
- (337) 205-5855
- NPI assigned
- Oct 19, 2021
- 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 | 14127 | LA | Primary |
Addresses
Primary practice location
3423 NW Evangeline Trwy
Carencro, LA 70520-6241
Mailing address
1085 Vizinat Rd
Ville Platte, LA 70586-6977
Phone (337) 692-2155
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jul 1, 2023 through Jul 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1634601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636070400000",
"number": "1689337487",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1085 VIZINAT RD",
"city": "VILLE PLATTE",
"state": "LA",
"postal_code": "705866977",
"telephone_number": "337-692-2155"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3423 NW EVANGELINE TRWY",
"city": "CARENCRO",
"state": "LA",
"postal_code": "705206241",
"telephone_number": "337-205-5855"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FONTENOT",
"first_name": "NICOLE",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-10-19",
"last_updated": "2021-11-05",
"certification_date": "2021-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "LA",
"license": "14127",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carencro, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.