Active NPI
Mark Chustz, LCSW
- Clinical Social Worker
- Saint Francisville, LA
National Provider Identifier
1740418342
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 2574
- Practice address
- 5621 Hilltop Cir
Saint Francisville, LA 70775-5620 - Phone
- (225) 931-6814
- NPI assigned
- Jun 23, 2009
- Sex
- Male
- 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 | 2574 | LA | Primary |
Addresses
Primary practice location
5621 Hilltop Cir
Saint Francisville, LA 70775-5620
Mailing address
77 Mill St
Westfield, MA 01085-4598
Phone (504) 920-7374
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 |
|---|---|---|---|
| 2574 | LA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1245715200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600214400000",
"number": "1740418342",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "77 MILL ST",
"city": "WESTFIELD",
"state": "MA",
"postal_code": "010854598",
"telephone_number": "504-920-7374"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5621 HILLTOP CIR",
"city": "SAINT FRANCISVILLE",
"state": "LA",
"postal_code": "707755620",
"telephone_number": "225-931-6814"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHUSTZ",
"first_name": "MARK",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-06-23",
"last_updated": "2020-09-16",
"certification_date": "2020-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "LA",
"license": "2574",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Francisville, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.