Healthcare Provider Details

I. General information

NPI: 1669986576
Provider Name (Legal Business Name): SOCIAL WORKS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2017
Last Update Date: 06/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 W PINHOOK RD STE 401
LAFAYETTE LA
70508
US

IV. Provider business mailing address

2020 W PINHOOK RD STE 401
LAFAYETTE LA
70508-3212
US

V. Phone/Fax

Practice location:
  • Phone: 337-962-3159
  • Fax: 337-534-8005
Mailing address:
  • Phone: 337-962-3159
  • Fax: 337-534-8005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number12132
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JODY HUTCHINSON
Title or Position: OWNER/CLINICIAN
Credential: MSW, LCSW
Phone: 337-962-3159