Acadiana Psychiatric Solutions LLC

Key facts

NPI

1275926230

Entity type

Organization (NPI type 2)

Primary specialty

Psychiatric/Mental Health Nurse Practitioner 363LP0808X

Legal business name

ACADIANA PSYCHIATRIC SOLUTIONS LLC

Practice address

217 Brevard CT Ste C
Alexandria, LA 71303-3997

Phone

(318) 545-2451

Fax

(866) 990-8296

NPI assigned

Mar 13, 2015

Organization subpart

No

Authorized official

Name

Mr. Mark Declouet, NP

Title

Owner/Ceo/Nurse Practitioner

Phone

(337) 322-2471

National Provider Directory

Locations

Specialties & licenses

Addresses

Other identifiers

Other names

• AXIS Behavioral Health and Recovery Doing business as

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 27, 2022.

{
    "created_epoch": "1426204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643241600000",
    "number": "1275926230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 53709",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705053709",
            "telephone_number": "337-205-6445",
            "fax_number": "337-735-9898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 BREVARD CT STE C",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713033997",
            "telephone_number": "318-545-2451",
            "fax_number": "866-990-8296"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5448 Provine Pl Ste A",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "LA",
            "postal_code": "713033983",
            "country_code": "US",
            "telephone_number": "318-545-2451",
            "fax_number": "866-990-8296",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "250 Ridgeway Dr Ste 3C",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "LA",
            "postal_code": "705033445",
            "country_code": "US",
            "telephone_number": "337-205-6445",
            "fax_number": "337-210-3058",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ACADIANA PSYCHIATRIC SOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-13",
        "last_updated": "2022-01-27",
        "certification_date": "2022-01-27",
        "status": "A",
        "authorized_official_last_name": "DECLOUET",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER/CEO/NURSE PRACTITIONER",
        "authorized_official_telephone_number": "337-322-2471",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2543491",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AXIS Behavioral Health and Recovery",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "AXIS Behavioral Health and Recovery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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