Individual provider Active NPI

Samuel Joseph Fusilier, LCSW

  • Clinical Social Worker
  • Eunice, LA
National Provider Identifier
1700834942
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1110 Issued in LA
Practice address
128 Adeline Dr
Eunice, LA 70535-6826
Phone
(337) 457-8456
Fax
(337) 363-1567
NPI assigned
May 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 1110 LA Primary

Addresses

Primary practice location

128 Adeline Dr
Eunice, LA 70535-6826

Mailing address

128 Adeline Dr
Eunice, LA 70535-6826
Phone (337) 457-8456

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
I20081002000264 LA Practitioner - Clinical Social Worker 9234207333 Practice locations: Eunice, LA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

128 Adeline Dr
Eunice, LA 70535-6826
Phone (337) 457-8456

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1110LAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcare Advantage 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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700834942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 ADELINE DR",
            "city": "EUNICE",
            "state": "LA",
            "postal_code": "705356826",
            "telephone_number": "337-457-8456",
            "fax_number": "337-363-1567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 ADELINE DR",
            "city": "EUNICE",
            "state": "LA",
            "postal_code": "705356826",
            "telephone_number": "337-457-8456",
            "fax_number": "337-363-1567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUSILIER",
        "first_name": "SAMUEL",
        "middle_name": "JOSEPH",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "1110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eunice, LA

Sources for this page

Verify at the official NPI Registry.