Individual provider Active NPI

Dianna Flowers Fruge, LCSW

  • Clinical Social Worker
  • Lake Charles, LA
National Provider Identifier
1922436120
Registry record updated Oct 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
4506 Issued in LA
Practice address
2115 Fitzenreiter Rd
SBHC
Lake Charles, LA 70601-1139
Phone
(337) 217-4890
Fax
(337) 491-7132
NPI assigned
Oct 24, 2013
Last updated
Oct 24, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2013

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 4506 LA Primary

Addresses

Primary practice location

2115 Fitzenreiter Rd
SBHC
Lake Charles, LA 70601-1139

Mailing address

1216 Texas St
Sulphur, LA 70663-3623
Phone (337) 625-8975

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

LicenseStateTypeSpecialty
4506LAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1382572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382572800000",
    "number": "1922436120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1216 TEXAS ST",
            "city": "SULPHUR",
            "state": "LA",
            "postal_code": "706633623",
            "telephone_number": "337-625-8975",
            "fax_number": "337-491-7132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 FITZENREITER RD",
            "address_2": "SBHC",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706011139",
            "telephone_number": "337-217-4890",
            "fax_number": "337-491-7132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRUGE",
        "first_name": "DIANNA",
        "middle_name": "FLOWERS",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-10-24",
        "last_updated": "2013-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "4506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2013; 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.