=====================================================
General NPI Number Information
=====================================================
NPI Number | 1295831345
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ROBERT G AEBLI LCSW-BACS
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/16/2006
-----------------------------------------------------
Last Update Date | 12/12/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1405 W PINHOOK RD STE 102
-----------------------------------------------------
City | LAFAYETTE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70503-3100
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 337-761-6001
-----------------------------------------------------
Fax | 337-735-4005
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1105 HUDSON LN
-----------------------------------------------------
City | MONROE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 71201-6003
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 318-322-6500
-----------------------------------------------------
Fax | 318-322-5118
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | 12149
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------