Individual provider Active NPI

Malcolm James Dugas Jr., MSW,LCSW,ACSW

  • Clinical Social Worker
  • Houma, LA
National Provider Identifier
1922080902
Registry record updated Mar 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
4615 Issued in LA
Practice address
209 Bayou Gardens Blvd.
Suite 403
Houma, LA 70364-1420
Phone
(985) 209-1974
Fax
(985) 872-4707
NPI assigned
Nov 16, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2015

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 4615 LA Primary

Addresses

Primary practice location

209 Bayou Gardens Blvd.
Suite 403
Houma, LA 70364-1420

Mailing address

PO Box 20355
Houma, LA 70360-0355
Phone (985) 209-1974

Other identifiers 1

IdentifierTypeStateIssuer
1470848MedicaidLA

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
I20040917001010 LA Practitioner - Clinical Social Worker 8123096161 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

209 Bayou Gardens Blvd
Suite K4
Houma, LA 70364-1420
Phone (985) 209-1974

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4615LAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Malcolm J. Dugas Jr. Clinical CurrentSince May 1, 2004 Accepting new patients
Terrebonne Parish Hospital Service District #1 Past Accepting new patients

Locations

8120 Main St
Ste 403
Houma, LA 70360
Phone (985) 868-3737

209 Bayou Gardens Blvd
Ste K4
Houma, LA 70364
Phone (985) 209-1974

6472 W Main St
Houma, LA 70360
Phone (985) 209-0953

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": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427760000000",
    "number": "1922080902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20355",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703600355",
            "telephone_number": "985-209-1974",
            "fax_number": "985-872-4707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 BAYOU GARDENS BLVD.",
            "address_2": "SUITE 403",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703641420",
            "telephone_number": "985-209-1974",
            "fax_number": "985-872-4707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUGAS",
        "first_name": "MALCOLM",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "MSW,LCSW,ACSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-16",
        "last_updated": "2015-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "4615",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1470848",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houma, LA

Sources for this page

Verify at the official NPI Registry.