Jake Roger, LMSW – Social Worker in Meraux, LA

Key facts

NPI: 1720445554
Entity type: Individual (NPI type 1)
Primary specialty: Social Worker 104100000X
License: 12207 (LA)
Practice address: 3229 Debouchel Blvd
Meraux, LA 70075-2220
Phone: (504) 575-9036
NPI assigned: Jan 25, 2016
Sex: Male
Sole proprietor: Yes

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
12207	LA	MD	Social Worker

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Social Worker	104100000X	12207	LA	Yes

Addresses

Primary practice location

3229 Debouchel Blvd
Meraux, LA 70075-2220

Mailing address

3229 Debouchel Blvd
Meraux, LA 70075-2220

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 25, 2016.

{
    "created_epoch": "1453680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453680000000",
    "number": "1720445554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3229 DEBOUCHEL BLVD",
            "city": "MERAUX",
            "state": "LA",
            "postal_code": "700752220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3229 DEBOUCHEL BLVD",
            "city": "MERAUX",
            "state": "LA",
            "postal_code": "700752220",
            "telephone_number": "504-575-9036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGER",
        "first_name": "JAKE",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-01-25",
        "last_updated": "2016-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "LA",
            "license": "12207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meraux, LA

All providers in Meraux, LA · Social Worker in Louisiana

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 25, 2016. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.