MEDICARE: DESTINY WEBRE LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	16653	LA

General Provider Information

NPI Number	:	1902765191
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DESTINY WEBRE LCSW

Provider Business Mailing Address
First Line	:	16085 E DOMIANO LN
Second Line	:
City	:	HAMMOND
State	:	LA
Zip	:	70401-7238
Country	:	US
Telephone Number	:	225-394-5143
Fax Number	:

Provider Business Practice Location Address
First Line	:	16085 E DOMIANO LN
Second Line	:
City	:	HAMMOND
State	:	LA
Zip	:	70401-7238
Country	:	US
Telephone Number	:	225-394-5143
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/21/2026
Last Update Date	:	01/21/2026

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