Active NPI
Kathryn Dietzway, LCSW
- Clinical Social Worker
- Lafayette, LA
National Provider Identifier
1821650987
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 13344
- Practice address
- 345 Doucet Rd Ste 217
Lafayette, LA 70503-3488 - Phone
- (337) 202-5183
- NPI assigned
- Jun 28, 2019
- 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 | 13344 | LA | Primary |
Addresses
Primary practice location
345 Doucet Rd Ste 217
Lafayette, LA 70503-3488
Mailing address
206 Corona Dr
Lafayette, LA 70503-4604
Phone (318) 787-7177
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 |
|---|---|---|---|
| 13344 | LA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1561680000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562025600000",
"number": "1821650987",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "206 CORONA DR",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "705034604",
"telephone_number": "318-787-7177"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "345 DOUCET RD STE 217",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "705033488",
"telephone_number": "337-202-5183"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIETZWAY",
"first_name": "KATHRYN",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-06-28",
"last_updated": "2019-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "LA",
"license": "13344",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lafayette, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.