Walter Breaux III, LPC-S, PH.D.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

005553 Issued in GA

Practice address

308 Pellerin Dr
Kenner, LA 70065-2553

Phone

(504) 237-1264

NPI assigned

Apr 7, 2009

Last updated

Apr 22, 2019By the provider in NPPES

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1239062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555891200000",
    "number": "1346483385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 PELLERIN DR",
            "city": "KENNER",
            "state": "LA",
            "postal_code": "700652553",
            "telephone_number": "504-237-1264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 PELLERIN DR",
            "city": "KENNER",
            "state": "LA",
            "postal_code": "700652553",
            "telephone_number": "504-237-1264"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3575 Macon Rd",
            "address_2": "Suite 5",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "GA",
            "postal_code": "319078200",
            "country_code": "US",
            "telephone_number": "706-565-5927",
            "fax_number": "706-565-0827",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BREAUX",
        "first_name": "WALTER",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "LPC-S, PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-07",
        "last_updated": "2019-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "005553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda E. Bourgeois, RDN
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• Amanda Jo Brennan, BS/P
• Erin Elizabeth Brewer, M.D.
• Pat-Shelia Brewer
• Connie S Brider, RN, APRN,ACM-RN
• Rosheila Bridges

• Professional Counselor in Kenner, LA
• Providers in Kenner, LA by specialty
• Professional Counselor in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2019; 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.