Theresa Lavelle Earthly, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2476 Issued in LA

Practice address

1217 Willow Glen River Rd
Alexandria, LA 71302-5454

Phone

(318) 487-4400

Fax

(318) 487-0525

NPI assigned

Dec 29, 2010

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Theresa Lavelle Addison Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1293580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293580800000",
    "number": "1780988097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1217 WILLOW GLEN RIVER RD",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713025454",
            "telephone_number": "318-487-4400",
            "fax_number": "318-487-0525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1217 WILLOW GLEN RIVER RD",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713025454",
            "telephone_number": "318-487-4400",
            "fax_number": "318-487-0525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EARTHLY",
        "first_name": "THERESA",
        "middle_name": "LAVELLE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-29",
        "last_updated": "2010-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "2476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THERESA",
            "last_name": "ADDISON",
            "middle_name": "LAVELLE",
            "credential": "LCSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Anjana Danielle Dyer
• Rebekah Louise Dyer, LCSW
• Skylar Renee Dyer, PLPC
• Earl Sumbler Memorial Healthcare Center
• Breona Earthly
• Easter Seals Louisiana
• Easter Seals Louisiana
• Kelby Dayne Ebare
• Karin Aletta Ebersohn, LPC
• Eckerd Youth Alternatives, Inc. Dba Eckerd Connects

• Clinical Social Worker in Alexandria, LA
• Providers in Alexandria, LA by specialty
• Clinical Social Worker in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.