=====================================================
General NPI Number Information
=====================================================
NPI Number | 1033863600
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CARSYN BOBRYCKI LMSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/11/2022
-----------------------------------------------------
Last Update Date | 07/22/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 54016 HIGHWAY 1062
-----------------------------------------------------
City | LORANGER
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70446-3538
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 985-606-9000
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 15265 BRANDON DR
-----------------------------------------------------
City | PONCHATOULA
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70454-6482
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 225-993-1559
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number | 14790
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | 14790
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------