Active NPI
Brooke Henry, BS
- Case Manager/Care Coordinator
- Opelousas, LA
National Provider Identifier
1114564689
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 119 W Vine St
Opelousas, LA 70570-5153 - Phone
- (337) 692-3392
- Fax
- (337) 284-3034
- NPI assigned
- Dec 4, 2019
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Case Manager/Care Coordinator | 171M00000X | LA | Primary |
Addresses
Primary practice location
119 W Vine St
Opelousas, LA 70570-5153
Mailing address
119 W Vine St
Opelousas, LA 70570-5153
Phone (337) 692-3392
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00000000000 | Medicaid | LA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | jaidablaire@gmail.com |
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
- Bachelor of Science
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1575417600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1592956800000",
"number": "1114564689",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "119 W VINE ST",
"city": "OPELOUSAS",
"state": "LA",
"postal_code": "705705153",
"telephone_number": "337-692-3392",
"fax_number": "337-284-3034"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "119 W VINE ST",
"city": "OPELOUSAS",
"state": "LA",
"postal_code": "705705153",
"telephone_number": "337-692-3392",
"fax_number": "337-284-3034"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENRY",
"first_name": "BROOKE",
"credential": "BS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-12-04",
"last_updated": "2020-06-24",
"certification_date": "2020-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "LA",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00000000000",
"state": "LA"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "jaidablaire@gmail.com",
"affiliation": "N",
"address_1": "124 Abigayle Row Ste 4",
"city": "Scott",
"state": "LA",
"country_code": "US",
"postal_code": "705838909",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Opelousas, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.