Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kiley P Cedotal, LCSW-BACS, FACHE

Individual provider Clinical Social Worker · NPI 1194537597

Kiley P Cedotal, LCSW-BACS, FACHE is a Clinical Social Worker in Ponchatoula, Louisiana. Qualified in 1999, 27 years ago. Practices as a sole proprietor. Licensed in Louisiana.

Years since qualifying
27
Licensed in
LA
In the registry since
2025

Practice location Address checks out

532 Ponderosa Dr
Ponchatoula, LA 70454-9428
Phone: (225) 715-8768
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 6181 (LA)

Record details

NPI number1194537597
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW-BACS , FACHE
Sole proprietorYes
NPI enumeratedJanuary 22, 2025
Last updated in NPPESJanuary 22, 2025
Certification dateJanuary 22, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 1999 (27 years in practice)
Accepts Medicare assignment Not indicated

Other providers in Ponchatoula