Active NPI
Corbyn D'Ann Blouin
- Behavior Technician
- Denham Springs, LA
National Provider Identifier
1033863477
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 011824799
- Practice address
- 32871 La Highway 16
Denham Springs, LA 70706-0960 - Phone
- (225) 349-7960
- NPI assigned
- Feb 4, 2022
- Last updated
- Feb 4, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | 011824799 | LA | Primary |
Addresses
Primary practice location
32871 La Highway 16
Denham Springs, LA 70706-0960
Mailing address
5088 Myrtle Hill Ave
Zachary, LA 70791-3060
Phone (225) 328-4852
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 011824799 | LA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1643932800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643932800000",
"number": "1033863477",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5088 MYRTLE HILL AVE",
"city": "ZACHARY",
"state": "LA",
"postal_code": "707913060",
"telephone_number": "225-328-4852"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "32871 LA HIGHWAY 16",
"city": "DENHAM SPRINGS",
"state": "LA",
"postal_code": "707060960",
"telephone_number": "225-349-7960"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLOUIN",
"first_name": "CORBYN",
"middle_name": "D'ANN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-02-04",
"last_updated": "2022-02-04",
"certification_date": "2022-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "LA",
"license": "011824799",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Denham Springs, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.