DR. JOHN FRANCIS FIDANZA III (NPI# 1902801392) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902801392 |
| Entity Type | Individual |
| Full Name | DR. JOHN FRANCIS FIDANZA III |
| Credential | PSY.D. |
| Practice Address |
6351 Main St Zachary LA 70791-4038 |
| Mailing Address |
Po Box 770 Zachary LA 70791-0770 |
| Practice Telephone | 2253062000 |
| Practice Fax Number | 2256581282 |
| Mailing Telephone | 2253062000 |
| Mailing Fax Number | 2256581249 |
| Enumeration Date | 2005-06-14 |
| Last Update Date | 2015-07-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TP0016X |
Psychologist Specialization: Prescribing (Medical) |
1040MP | LA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 2125958 | 05 |
| Street Address |
6351 MAIN ST |
| City | ZACHARY |
| State | LA |
| Zip Code | 70791-4038 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700365731 | Ashley Lee | Nurse Practitioner | 6351 Main St, Zachary, LA 70791-4038 | 2018-08-09 |
| 1508360777 | Lisa Broadnax | Counselor | 6351 Main St, Zachary, LA 70791-4038 | 2018-03-21 |
| 1982088175 | Shantelle Jacobs | Counselor | 6351 Main St, Zachary, LA 70791-4038 | 2015-07-17 |
| 1497143663 | Kenya Lavergne | Social Worker | 6351 Main St, Zachary, LA 70791-4038 | 2014-12-22 |
| 1750721403 | Mary A Clavelle | Dietitian, Registered | 6351 Main St, Zachary, LA 70791-4038 | 2013-06-26 |
| 1225374481 | Khuong Nguyen Cheuk | Dentist | 6351 Main St, Zachary, LA 70791-4038 | 2012-12-17 |
| 1245582626 | Sarah Smith | Dental Hygienist | 6351 Main St, Zachary, LA 70791-4038 | 2012-10-09 |
| 1376866848 | Keith Westerfield | Psychologist | 6351 Main St, Zachary, LA 70791-4038 | 2010-03-11 |
| 1538398730 | Southeast Community Health Systems | Clinic/Center | 6351 Main St, Zachary, LA 70791-4038 | 2009-07-08 |
| 1831245844 | Felicia Melody Smith | Social Worker | 6351 Main St, Zachary, LA 70791-4038 | 2007-01-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164054110 | Amandalin Hopkins Whittington | Occupational Therapist | 4555 Bert St, Zachary, LA 70791 | 2020-02-07 |
| 1346883352 | Dr Terrell S Manuel LLC | Nurse Practitioner | 12038 Greenwell Springs/port Hudson Road, Zachary, LA 70791 | 2019-10-22 |
| 1902451131 | Edward Williams | Case Manager/Care Coordinator | 22749 Fairvway View Drive, Zachary, LA 70791 | 2019-08-05 |
| 1275090672 | Ashley Talbot Thompson | Nurse Practitioner | 5645 Newell St, Zachary, LA 70791 | 2019-02-22 |
| 1659867265 | American Oncology Partners, P.a. | Internal Medicine | 1673 E Mount Pleasant Rd Unit F102, Zachary, LA 70791 | 2018-07-06 |
| 1629574447 | Darren Keith Ryland | Massage Therapist | 5037 Main St, Suite B, Zachary, LA 70791 | 2018-04-02 |
| 1306355102 | Radiation Oncology Center - Zachary | Clinic/Center | 6180 Main Street, Ste B, Zachary, LA 70791 | 2017-09-25 |
| 1861913568 | Sylvia Simone Henderson | Case Manager/Care Coordinator | 8932 Highland Oaks Ave, Zachary, LA 70791 | 2017-07-03 |
| 1346770674 | Gaylian Anthony White | Counselor | 20051 Old Senic Hwy, Apt 2605, Zachary, LA 70791 | 2017-06-19 |
| 1104353218 | Jessica Rene Griffin | Counselor | 6676 Lakeridge Drive, Zachary, LA 70791 | 2017-05-19 |
| Find all providers in zip 70791 | ||||
| Taxonomy Code | 103TP0016X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Prescribing (Medical) |
| Those licensed psychologists who have completed specialized, post-doctoral training in psychopharmacology, passed a national proficiency examination in psychopharmacology, and who are authorized by state statute to prescribe medications, in accordance with their state law and state licensing authority, for the evaluation, diagnosis, management and treatment of mental, nervous, emotional, behavioral, and related disorders. |
| Notes: Source: Louisiana Academy of Medical Psychologists Note: Some states issue licenses under Medical Psychologist. [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790297182 | George S. Park, Phd., Mp., A Psychology Corporation | Psychologist | 2285 Benton Rd Ste 401, Bossier City, LA 71111-7933 | 2017-10-25 |
| 1669887907 | John Courtney LLC | Psychologist | 118 Terra Bella Blvd, Suite 101, Covington, LA 70433-8148 | 2014-06-25 |
| 1730520925 | Faw Services, LLC | Psychologist | 223 Bellingrath Pl, Madisonville, LA 70447-3421 | 2013-07-16 |
| 1134418502 | Psychological Health Care of South Louisiana | Psychologist | 1016 Houma St, Houma, LA 70360-4420 | 2011-04-06 |
| 1922234566 | Felicia Ann Whiteman | Psychologist | 2331 Carey St, Slidell, LA 70458-3627 | 2009-06-10 |
| 1861627465 | Lakisha Shantell Williams | Psychologist | 1409 Kirkman St, Lake Charles, LA 70601-5344 | 2009-05-26 |
| 1710101373 | Rebecca Faye Nolan | Psychologist | 111 Carroll St, Shreveport, LA 71105-4203 | 2007-04-12 |
| 1013131267 | Dr. Maria B. Cruse Apmg | Psychologist | 604 North Acadia Road, Suite 201, Thibodaux, LA 70301 | 2007-04-12 |
| 1093860371 | Maxine Elizabeth Campbell-flint | Psychologist | 412 N 4th St, Suite 100, Baton Rouge, LA 70802-5523 | 2007-01-24 |
| 1104925932 | Williams Consulting Inc. | Psychologist | 1410 Royal Ave, Monroe, LA 71201-5608 | 2006-09-21 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.