Pediatric Therapy and Learning Center LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

4981 Issued in LA

Legal business name

PEDIATRIC THERAPY AND LEARNING CENTER LLC

Practice address

108 Energy Pkwy
Lafayette, LA 70508-3818

Phone

(337) 504-4244

Fax

(337) 706-7612

NPI assigned

Dec 10, 2007

Organization subpart

No

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

Authorized official

Name

Marsha Legoullon, MA, CCCD-SLPNPI 1295704294

Title

Clinical Director

Phone

(337) 504-4244

Specialties & licenses 2

Addresses

Tax ID family

Pediatric Therapy and Learning Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Pediatric Therapy and Learning Center

  • Speech-Language Pathologist
  • Lafayette, LA
  • NPI 1427338474
  NPD tax ID

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Marsha Legoullon, CCC-SLP

  • Speech-Language Pathologist
  • Abbeville, LA
  • NPI 1295704294
  NPD Authorized official
• Amy Boudreaux, M.S.-CCC, SLP

  • Speech-Language Pathologist
  • Lafayette, LA
  • NPI 1316523558
  NPD
• Rani P. Broussard, P.T.

  • Speech-Language Pathologist
  • Abbeville, LA
  • NPI 1225292543
  NPD (past)
• Jill Douglass, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Lafayette, LA
  • NPI 1124353891
  NPD (past)
• Kristine Marie Menard, L.O.T.R.

  • Occupational Therapist
  • Covington, LA
  • NPI 1023253390
  NPD (past)

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

{
    "created_epoch": "1197244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686355200000",
    "number": "1275716524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 ENERGY PKWY",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705083818",
            "telephone_number": "337-504-4244",
            "fax_number": "337-706-7612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 ENERGY PKWY",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705083818",
            "telephone_number": "337-504-4244",
            "fax_number": "337-706-7612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC THERAPY AND LEARNING CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-10",
        "last_updated": "2023-06-10",
        "certification_date": "2022-06-14",
        "status": "A",
        "authorized_official_last_name": "LEGOULLON",
        "authorized_official_first_name": "MARSHA",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "337-504-4244",
        "authorized_official_credential": "MA, CCCD-SLP"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "LA",
            "license": "4981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Lafayette, LA
• Providers in Lafayette, LA by specialty
• Speech-Language Pathologist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2023; 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.