Fatonia Beaudoin

Primary specialty

Social WorkerTaxonomy code 104100000X

License

17521 Issued in LA

Practice address

3018 Old Minden Rd Ste 1117
Bossier City, LA 71112

Phone

(318) 746-1935

NPI assigned

Jan 9, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1483920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1174069652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3018 OLD MINDEN RD STE 1117",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711122497",
            "telephone_number": "318-746-1935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3018 OLD MINDEN RD STE 1117",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "71112",
            "telephone_number": "318-746-1935"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2210 Line Ave Ste 207",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711042134",
            "country_code": "US",
            "telephone_number": "318-675-1112",
            "fax_number": "866-307-9980",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEAUDOIN",
        "first_name": "FATONIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-09",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "LA",
            "license": "17521",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2160699",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Social Worker in Bossier City, LA
• Providers in Bossier City, LA by specialty
• Social Worker in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.