Active NPI
Carmen Dupre Broussard, PH.D.
- School Psychologist
- Napoleonville, LA
National Provider Identifier
1093982787
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 808
- Practice address
- 3965 Highway 1
Napoleonville, LA 70390-8728 - Phone
- (985) 688-1240
- NPI assigned
- May 12, 2008
- 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 |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 808 | LA | Primary |
Addresses
Primary practice location
3965 Highway 1
Napoleonville, LA 70390-8728
Mailing address
3965 Highway 1
Napoleonville, LA 70390-8728
Phone (985) 688-1240
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 808 | LA | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Milestones Behavioral Services LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Behavior Analyst
- Lake Charles, LA
- NPI 1669735502
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210550400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210550400000",
"number": "1093982787",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3965 HIGHWAY 1",
"city": "NAPOLEONVILLE",
"state": "LA",
"postal_code": "703908728",
"telephone_number": "985-688-1240"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3965 HIGHWAY 1",
"city": "NAPOLEONVILLE",
"state": "LA",
"postal_code": "703908728",
"telephone_number": "985-688-1240"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROUSSARD",
"first_name": "CARMEN",
"middle_name": "DUPRE",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-05-12",
"last_updated": "2008-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "LA",
"license": "808",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Napoleonville, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.