Individual provider Active NPI

Michele Vidrine Nelson, LCSW

  • Clinical Social Worker
  • Baton Rouge, LA
National Provider Identifier
1912066473
Registry record updated May 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3345 Issued in LA
Practice address
380 College Hill Dr
Baton Rouge, LA 70808-4943
Phone
(504) 832-4940
Fax
(504) 270-1294
NPI assigned
Dec 8, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2023

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 3345 LA Primary

Addresses

Primary practice location

380 College Hill Dr
Baton Rouge, LA 70808-4943

Mailing address

5261 Highland Rd # 199
Baton Rouge, LA 70808-6547
Phone (504) 832-4940

Other identifiers 1

IdentifierTypeStateIssuer
$$$$$$$$$OtherLABLUE CROSS

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
I20070219000202 LA Practitioner - Clinical Social Worker 8426150616 Practice locations: Baton Rouge, LA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

Baton Rouge, LA 70808
Phone (504) 832-4940

5261 Highland Rd
Suite 199
Baton Rouge, LA 70808-6547

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3345LAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Michele V. Nelson L.C.S.W. LLC Clinical CurrentSince Jul 5, 2020 Accepting new patients
Teladoc Health Medical Group, P.a. Clinical Current Accepting new patients

Locations

5261 Highland Rd
Baton Rouge, LA 70808

Interoperability endpoints

  • Direct secure messaging: michelenelson@tdh.allscriptsdirect.net

Organizations & group practices 2

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": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683849600000",
    "number": "1912066473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5261 HIGHLAND RD # 199",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708086547",
            "telephone_number": "504-832-4940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 COLLEGE HILL DR",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708084943",
            "telephone_number": "504-832-4940",
            "fax_number": "504-270-1294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "MICHELE",
        "middle_name": "VIDRINE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-08",
        "last_updated": "2023-05-12",
        "certification_date": "2023-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "3345",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "$$$$$$$$$",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.