Individual provider Active NPI

Brandon J Adams, LPC

  • Professional Counselor
  • Thibodaux, LA
National Provider Identifier
1144878703
Registry record updated Aug 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
7121 Issued in LA
Practice address
1101 Audubon Ave Ste S1
Thibodaux, LA 70301-4957
Phone
(985) 492-6170
NPI assigned
Aug 27, 2019
Last updated
Aug 13, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 7121 LA Primary

Addresses

Primary practice location

1101 Audubon Ave Ste S1
Thibodaux, LA 70301-4957

Mailing address

110 Highway 304
Thibodaux, LA 70301-7347
Phone (000) 000-0000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240419003274 LA Practitioner - Mental Health Counselor 4789023946 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

144 W 134TH PL
Cut Off, LA 70345-4128
Phone (985) 632-6233

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7121LAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lafourche Parish Hospital Service District No.1 CurrentSince Mar 2, 2024 Accepting new patients
Lafourche Parish Hospital Service District No.1 CurrentSince Mar 2, 2024 Accepting new patients
Broadlands Family Services, LLC Professional PastSince Sep 1, 2019 Accepting new patients
Broadlands Family Transportation Services, LLC PastSince Sep 1, 2019 Accepting new patients
Lafourche Parish Hospital Service District No. 1 PastSince Jul 7, 2023 Accepting new patients

Locations

144 W 134th Pl
Cut Off, LA 70345
Phone (985) 325-9750

200 W 134th Pl
Cut Off, LA 70345
Phone (985) 325-9300

Interoperability endpoints

  • Direct secure messaging: brandon.adams.1@748.direct.athenahealth.com
  • Direct secure messaging: brandon.adams.2@748.direct.athenahealth.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1566864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628812800000",
    "number": "1144878703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 HIGHWAY 304",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703017347",
            "telephone_number": "000-000-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 AUDUBON AVE STE S1",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703014957",
            "telephone_number": "985-492-6170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAMS",
        "first_name": "BRANDON",
        "middle_name": "J",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-27",
        "last_updated": "2021-08-13",
        "certification_date": "2021-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "LA",
            "license": "7121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thibodaux, LA

Sources for this page

Verify at the official NPI Registry.