Healthcare Provider Details

I. General information

NPI: 1700353752
Provider Name (Legal Business Name): SUNNIE S. FROST MSW, CSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SUNNIE S FROST MSW, CSW

II. Dates (important events)

Enumeration Date: 10/29/2018
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 E MISSISSIPPI AVE STE 1
RUSTON LA
71270-3905
US

IV. Provider business mailing address

305 E MISSISSIPPI AVE STE 1
RUSTON LA
71270-3905
US

V. Phone/Fax

Practice location:
  • Phone: 318-202-3700
  • Fax: 318-202-3707
Mailing address:
  • Phone: 318-202-3607
  • Fax: 318-202-3707

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number17487
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: