Active NPI
Tracy Nicole Thibodeaux, MS, CF-SLP
- Speech-Language Pathologist
- Lafayette, LA
National Provider Identifier
1376869008
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 6245
- Practice address
- 2810 Ambassador Caffery Pkwy
Lafayette, LA 70506-5906 - Phone
- (337) 981-2949
- NPI assigned
- Apr 20, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 6245 | LA | Primary |
Addresses
Primary practice location
2810 Ambassador Caffery Pkwy
Lafayette, LA 70506-5906
Mailing address
317 Arceneaux Cir
Scott, LA 70583-4019
Phone (337) 316-2238
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6245 | LA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1271721600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1271721600000",
"number": "1376869008",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "317 ARCENEAUX CIR",
"city": "SCOTT",
"state": "LA",
"postal_code": "705834019",
"telephone_number": "337-316-2238"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2810 AMBASSADOR CAFFERY PKWY",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "705065906",
"telephone_number": "337-981-2949"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THIBODEAUX",
"first_name": "TRACY",
"middle_name": "NICOLE",
"credential": "MS, CF-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-04-20",
"last_updated": "2010-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "LA",
"license": "6245",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lafayette, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.