Laura D Thiesen, LCSW | |
1112 E Ascension Complex Blvd, Gonzales, LA 70737-4265 | |
(225) 450-1016 | |
(225) 450-1150 |
Full Name | Laura D Thiesen |
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Gender | Female |
Speciality | Social Worker - Clinical |
Location | 1112 E Ascension Complex Blvd, Gonzales, Louisiana |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1972852143 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 1187 (Alaska) | Secondary |
1041C0700X | Social Worker - Clinical | 17690 (Louisiana) | Primary |
Entity Name | Our Lady Of The Lake Physician Group Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1033494943 PECOS PAC ID: 4587849781 Enrollment ID: O20120529000377 |
Mailing Address | Practice Location Address |
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Laura D Thiesen, LCSW 5959 S Sherwood Forest Blvd, Baton Rouge, LA 70816-6038 Ph: (225) 450-1016 | Laura D Thiesen, LCSW 1112 E Ascension Complex Blvd, Gonzales, LA 70737-4265 Ph: (225) 450-1016 |
David Frank Vogt, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 41080 Lakeway Cove Ave, Gonzales, LA 70737 Phone: 225-445-3442 | |
Nekia M Weber, LMSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 6122 Tezcuco Ct, Gonzales, LA 70737 Phone: 504-329-5821 | |
Mr. Cary M Bahlinger, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1112 E Ascension Complex Avenue, Gonzales, LA 70737 Phone: 225-621-5770 Fax: 225-621-5168 | |
Mr. Ryan D Rife, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 1112 E Ascension Complex Blvd, Gonzales, LA 70737 Phone: 225-621-5770 Fax: 225-644-3208 | |
Angela M Sanders, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1112 E Ascension Complex Blvd, Gonzales, LA 70737 Phone: 225-621-5770 Fax: 225-644-5168 | |
Ms. Janis Kaye Ivey, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1024 E Ascension Complex Blvd, Gonzales, LA 70737 Phone: 225-644-4582 Fax: 225-644-3635 | |
Pilar T. Borne, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 1112 E Ascension Complex Blvd, Gonzales, LA 70737 Phone: 225-621-5770 Fax: 225-644-3208 |