Cardetra Thompson, LCSW-BACS

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6083 Issued in LA

Practice address

1724 N Burnside Ave Ste 7
Gonzales, LA 70737-2157

Phone

(225) 323-5996

Fax

(225) 644-6261

NPI assigned

Dec 1, 2015

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rise 'N'Shine Counseling Agency

  • Community/Behavioral Health Agency
  • Gonzales, LA
  • NPI 1003142845
  NPD (past) Authorized official

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

{
    "created_epoch": "1448928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448928000000",
    "number": "1871968909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 541",
            "city": "GEISMAR",
            "state": "LA",
            "postal_code": "707340541",
            "telephone_number": "225-323-5996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1724 N BURNSIDE AVE STE 7",
            "city": "GONZALES",
            "state": "LA",
            "postal_code": "707372157",
            "telephone_number": "225-323-5996",
            "fax_number": "225-644-6261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "CARDETRA",
        "credential": "LCSW-BACS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-01",
        "last_updated": "2015-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "6083",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1807869",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura D Thiesen, LCSW
• Thomas L. Ewing MD, Apmc (Ascension Urology)
• Dion Thomas
• Latesha Braud Thomas, PHARM.D.
• Sharday Thomas
• Kaleigh Vargas Thompson, BS,LAT,ATC
• Keona Thompson, LMSW
• Shamari Iman Thompson, LPM
• TJ&M Specialty Services LLC
• Christopher Breckenridge Todd, MHSA

• Clinical Social Worker in Gonzales, LA
• Providers in Gonzales, 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 1, 2015; 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.