Active NPI
Dana Bourgeois
- Professional Counselor
- Thibodaux, LA
National Provider Identifier
1063003135
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 7260
- Practice address
- 197 Jolie Oaks Blvd 197 Jolie Oaks Blvd
Thibodaux, LA 70301 - Phone
- (985) 413-2076
- NPI assigned
- Feb 1, 2021
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Counselor | 101YS0200X | LA | ||
| Professional Counselor | 101YP2500X | 7260 | LA | Primary |
Addresses
Primary practice location
197 Jolie Oaks Blvd 197 Jolie Oaks Blvd
Thibodaux, LA 70301
Mailing address
197 Jolie Oaks Blvd
Thibodaux, LA 70301
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 |
|---|---|---|---|
| 7260 | LA | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1612137600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1612137600000",
"number": "1063003135",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "197 JOLIE OAKS BLVD",
"city": "THIBODAUX",
"state": "LA",
"postal_code": "70301"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "197 JOLIE OAKS BLVD 197 JOLIE OAKS BLVD",
"city": "THIBODAUX",
"state": "LA",
"postal_code": "70301",
"telephone_number": "985-413-2076"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOURGEOIS",
"first_name": "DANA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-02-01",
"last_updated": "2021-02-01",
"certification_date": "2021-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YS0200X",
"taxonomy_group": "",
"desc": "Counselor, School",
"state": "LA",
"license": null,
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "LA",
"license": "7260",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Thibodaux, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.