Individual provider Active NPI

Vicki Ann Lebleu

  • Psychiatric/Mental Health Nurse Practitioner
  • Lake Charles, LA
National Provider Identifier
1386057891
Registry record updated Dec 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP07785 Issued in LA
Practice address
4105 Kirkman St
Lake Charles, LA 70607-4603
Phone
(337) 475-8022
NPI assigned
Jun 3, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP07785 LA Primary

Addresses

Primary practice location

4105 Kirkman St
Lake Charles, LA 70607-4603

Mailing address

P O Box 123977
Dept 3977
Dallas, TX 75312-3977
Phone (337) 494-2772

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140822000401 LA Practitioner - Nurse Practitioner 1254559917 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Resource Management Services of St. Landry, LLC CurrentSince Dec 23, 2022 Accepting new patients
Sulphur Psychiatry LLC Psychiatric/Mental Health CurrentSince Nov 21, 2021 Accepting new patients
Southwest Louisiana Hospital Association Inc CurrentSince May 8, 2022 Accepting new patients

Locations

2020 W Pinhook Rd
Ste 204
Lafayette, LA 70508
Phone (337) 261-8781

184 Williamsburg St
Lake Charles, LA 70605
Phone (337) 437-4014

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1401753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575936000000",
    "number": "1386057891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 123977",
            "address_2": "DEPT 3977",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753123977",
            "telephone_number": "337-494-2772",
            "fax_number": "337-494-2928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4105 KIRKMAN ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706074603",
            "telephone_number": "337-475-8022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEBLEU",
        "first_name": "VICKI",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-03",
        "last_updated": "2019-12-10",
        "certification_date": "2019-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "LA",
            "license": "AP07785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

Verify at the official NPI Registry.