Ashley Patrice Broussard

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

4155 Issued in AK

Practice address

1723 Kresky Ave
Centralia, WA 98531-8985

Phone

(360) 559-6201

NPI assigned

Apr 27, 2017

Last updated

Jul 25, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1493251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564012800000",
    "number": "1376078246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1723 KRESKY AVE",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985318985",
            "telephone_number": "360-559-6201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1723 KRESKY AVE",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985318985",
            "telephone_number": "360-559-6201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUSSARD",
        "first_name": "ASHLEY",
        "middle_name": "PATRICE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-27",
        "last_updated": "2019-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "CG 60714499",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AK",
            "license": "4155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alejandro Bribiezcas
• John E Bridges, D.C.
• Jennifer Louise Brinson, LMP
• Lawrence Eugene Britten, M.A.
• Kimberly Ann Brooks
• Jennifer Dianna Brown, ARNP
• Jeremy Patrick Brown, RPH
• Sarahya D Brown
• Michelle Brumfield
• Karen Diane Brunson, MSW

• Addiction (Substance Use Disorder) Counselor in Centralia, WA
• Providers in Centralia, WA by specialty
• Addiction (Substance Use Disorder) Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 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.