Laura D Thiesen, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

17690 Issued in LA

Practice address

1112 E Ascension Complex Blvd
Gonzales, LA 70737-4265

Phone

(225) 450-1016

Fax

(225) 450-1150

NPI assigned

Sep 4, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Laura V Thiesen Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1346716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694044800000",
    "number": "1972852143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 S SHERWOOD FOREST BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708166038",
            "telephone_number": "225-450-1016",
            "fax_number": "225-765-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 E ASCENSION COMPLEX BLVD",
            "city": "GONZALES",
            "state": "LA",
            "postal_code": "707374265",
            "telephone_number": "225-450-1016",
            "fax_number": "225-450-1150"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Mile 187 Glenn Hwy",
            "address_purpose": "LOCATION",
            "city": "Glennallen",
            "state": "AK",
            "postal_code": "995880589",
            "country_code": "US",
            "telephone_number": "907-822-3203",
            "fax_number": "907-822-5805",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THIESEN",
        "first_name": "LAURA",
        "middle_name": "D",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-04",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AK",
            "license": "1187",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "17690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "THIESEN",
            "middle_name": "V",
            "credential": "LCSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• 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 Sep 7, 2023; 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.