Active NPI
Jenna-Clair Courville
- Addiction (Substance Use Disorder) Counselor
- Lafayette, LA
National Provider Identifier
1417688094
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- CIT-5408
- Practice address
- 401 W Vermilion St
Lafayette, LA 70501-6729 - Phone
- (337) 345-6120
- NPI assigned
- Jun 23, 2022
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CIT-5408 | LA | Primary |
Addresses
Primary practice location
401 W Vermilion St
Lafayette, LA 70501-6729
Mailing address
7660 Madison Rd
Maurice, LA 70555-3348
Phone (337) 962-8181
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CIT-5408 | LA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1655942400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655942400000",
"number": "1417688094",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7660 MADISON RD",
"city": "MAURICE",
"state": "LA",
"postal_code": "705553348",
"telephone_number": "337-962-8181"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 W VERMILION ST",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "705016729",
"telephone_number": "337-345-6120"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COURVILLE",
"first_name": "JENNA-CLAIR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-06-23",
"last_updated": "2022-06-23",
"certification_date": "2022-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "LA",
"license": "CIT-5408",
"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 Jun 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.