Individual provider Active NPI

Ann Lavergne, LCSW

  • Clinical Social Worker
  • Lafayette, LA
National Provider Identifier
1891370219
Registry record updated Mar 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
10552 Issued in LA
Practice address
215 Rue Fontaine
Lafayette, LA 70508-5742
Phone
(337) 945-3678
NPI assigned
Mar 17, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 10552 LA Primary

Addresses

Primary practice location

215 Rue Fontaine
Lafayette, LA 70508-5742

Mailing address

PO Box 583
Church Point, LA 70525-0583
Phone (337) 945-3678

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210407002835 LA Practitioner - Clinical Social Worker 2365859410 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

215 Rue Fontaine
Lafayette, LA 70508-5742
Phone (337) 945-3678

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10552LAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Ann Lavergne, LCSW, LLC Clinical CurrentSince Mar 24, 2021 Accepting new patients

Locations

215 Rue Fontaine
Lafayette, LA 70508
Phone (337) 577-5203

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1615939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615939200000",
    "number": "1891370219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 583",
            "city": "CHURCH POINT",
            "state": "LA",
            "postal_code": "705250583",
            "telephone_number": "337-945-3678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 RUE FONTAINE",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705085742",
            "telephone_number": "337-945-3678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVERGNE",
        "first_name": "ANN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-17",
        "last_updated": "2021-03-17",
        "certification_date": "2021-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "10552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

Verify at the official NPI Registry.