Active NPI
Donna Boudreaux, PH.D.
- Cognitive & Behavioral Psychologist
- Lafayette, LA
National Provider Identifier
1457786659
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cognitive & Behavioral Psychologist
- License
- 1238
- Practice address
- 119 Rue Fontaine
Lafayette, LA 70508 - Phone
- (337) 400-9395
- Fax
- (337) 991-9165
- NPI assigned
- Sep 6, 2013
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cognitive & Behavioral Psychologist | 103TB0200X | 1238 | LA | Primary |
| Clinical Child & Adolescent Psychologist | 103TC2200X | 1238 | LA | |
| Intellectual & Developmental Disabilities Psychologist | 103TM1800X | 1238 | LA | |
| School Psychologist | 103TS0200X | 1238 | LA |
Addresses
Primary practice location
119 Rue Fontaine
Lafayette, LA 70508
Mailing address
119 Rue Fontaine
Lafayette, LA 70508
Phone (337) 400-9395
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
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1238 | LA | MD | Clinical Child & Adolescent Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1378425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1378425600000",
"number": "1457786659",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "119 RUE FONTAINE",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "70508",
"telephone_number": "337-400-9395",
"fax_number": "337-991-9165"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "119 RUE FONTAINE",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "70508",
"telephone_number": "337-400-9395",
"fax_number": "337-991-9165"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOUDREAUX",
"first_name": "DONNA",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-09-06",
"last_updated": "2013-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "LA",
"license": "1238",
"primary": true
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "LA",
"license": "1238",
"primary": false
},
{
"code": "103TM1800X",
"taxonomy_group": "",
"desc": "Psychologist, Intellectual & Developmental Disabilities",
"state": "LA",
"license": "1238",
"primary": false
},
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "LA",
"license": "1238",
"primary": false
}
],
"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 Sep 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.