Active NPI
Doris S. Broadnax
- Addiction (Substance Use Disorder) Counselor
- Monroe, LA
National Provider Identifier
1073949178
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 1194
- Practice address
- 4800 S Grand St
Monroe, LA 71202-6412 - Phone
- (318) 362-3339
- NPI assigned
- Sep 20, 2013
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1194 | LA | Primary |
Addresses
Primary practice location
4800 S Grand St
Monroe, LA 71202-6412
Mailing address
4800 S Grand St
Monroe, LA 71202-6412
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 |
|---|---|---|---|
| 1194 | LA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1379635200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1379635200000",
"number": "1073949178",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4800 S GRAND ST",
"city": "MONROE",
"state": "LA",
"postal_code": "712026412"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4800 S GRAND ST",
"city": "MONROE",
"state": "LA",
"postal_code": "712026412",
"telephone_number": "318-362-3339"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROADNAX",
"first_name": "DORIS",
"middle_name": "S.",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-09-20",
"last_updated": "2013-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "LA",
"license": "1194",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Monroe, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.