Psychiatric Solutions LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

License

APO5139 Issued in LA

Legal business name

PSYCHIATRIC SOLUTIONS LLC

Practice address

1101 Audubon Ave
Thibodaux, LA 70301-4957

Phone

(985) 209-0953

Fax

(941) 295-7336

NPI assigned

Apr 7, 2011

Organization subpart

No

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

Authorized official

Name

Ms. Sandra Brommeland Gonzalez, NPNPI 1053428342

Title

Owner

Phone

(985) 209-0953

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sandra Lee Brommeland Gonzalez, APRN-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Thibodaux, LA
  • NPI 1053428342
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1302134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422316800000",
    "number": "1184913451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "929 BAYOU DULARGE RD",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703637614",
            "telephone_number": "985-209-0953",
            "fax_number": "941-295-7336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 AUDUBON AVE",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703014957",
            "telephone_number": "985-209-0953",
            "fax_number": "941-295-7336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHIATRIC SOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-07",
        "last_updated": "2015-01-27",
        "status": "A",
        "authorized_official_last_name": "BROMMELAND GONZALEZ",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "985-209-0953",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "LA",
            "license": "APO5139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Mental Health Clinic/Center in Thibodaux, LA
• Providers in Thibodaux, LA by specialty
• Adult Mental Health Clinic/Center in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.