Evan J Broussard, MS, PLPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

PLC8587 Issued in LA

Practice address

850 Kaliste Saloom Rd Ste 219
Lafayette, LA 70508-4230

Phone

(337) 504-4974

NPI assigned

May 24, 2021

Sex

Male

Sole proprietor

Yes

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.

• Acadian Counseling Center, LLC

  • Mental Health Counselor
  • Lafayette, LA
  • NPI 1366853376

  Mental Health

  NPD

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 26, 2021.

{
    "created_epoch": "1621814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621987200000",
    "number": "1316512239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7323 CEMETARY HWY",
            "city": "SAINT MARTINVILLE",
            "state": "LA",
            "postal_code": "705827903",
            "telephone_number": "337-380-9989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 KALISTE SALOOM RD STE 219",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705084230",
            "telephone_number": "337-504-4974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUSSARD",
        "first_name": "EVAN",
        "middle_name": "J",
        "credential": "MS, PLPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-24",
        "last_updated": "2021-05-26",
        "certification_date": "2021-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "LA",
            "license": "PLC8587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danner Jung Broussard
• David L Broussard, R.PH.
• Djenaba Broussard
• Edward James Broussard Jr., RPH
• Ericka Lafleur Broussard, NP
• Greg A Broussard, CRNA
• Hannah Broussard
• Jamie Ryan Broussard II, MSN, APRN, PMHNP-BC
• Jessica Broussard, FNP-C
• Joan T. Broussard, A.C.N.P.

• All providers in Lafayette, LA
• Mental Health Counselor in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2021; 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.