Koni Breaux Bridges, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2739 Issued in LA

Practice address

108 State St
Lake Charles, LA 70605-5718

Phone

(337) 625-5664

NPI assigned

Nov 6, 2007

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

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

Specialty

Clinical Social Worker

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Koni B. Bridges, LCSW LLC

  • Clinical Social Worker
  • Sulphur, LA
  • NPI 1770882847
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1194307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550188800000",
    "number": "1295915387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1865",
            "city": "SULPHUR",
            "state": "LA",
            "postal_code": "706641865",
            "telephone_number": "337-625-5664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 STATE ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706055718",
            "telephone_number": "337-625-5664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIDGES",
        "first_name": "KONI",
        "middle_name": "BREAUX",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-06",
        "last_updated": "2019-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "2739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Breaux, FNP
• Mallory Breaux
• Rachel Breaux
• Tamara Prince Breaux, PHARMD
• Annalise R Bricca, MD
• Bridgeway Psychiatric Center, Inc.
• Bridgeway Psychiatric Center, Inc.
• Bright Start Behavioral Services
• Brighter Days Counseling Services, LLC
• Brighttrail Transit II, LLC

• Clinical Social Worker in Lake Charles, LA
• Providers in Lake Charles, LA by specialty
• Clinical Social Worker in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.