Individual provider Active NPI

Stephanie Boyd

  • Addiction (Substance Use Disorder) Counselor
  • Lake Charles, LA
National Provider Identifier
1457807828
Registry record updated Mar 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
1395 Issued in LA
Practice address
315 Alamo St
Lake Charles, LA 70601-8528
Phone
(337) 513-6121
Fax
(877) 794-0365
NPI assigned
Aug 26, 2016
Last updated
Mar 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1395 LA Primary

Addresses

Primary practice location

315 Alamo St
Lake Charles, LA 70601-8528

Mailing address

2789 Crown LN
Lake Charles, LA 70605-8135
Phone (337) 491-3793

Other practice location 1

2789 Crown Ln
Lake Charles, LA 70605-8135
Phone (337) 491-3793

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

LicenseStateTypeSpecialty
1395LAMDCounseling Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Charles Addiction and Wellness Center Addiction (Substance Use Disorder) CurrentSince Apr 6, 2023 Accepting new patients

Locations

315 Alamo St
Lake Charles, LA 70601
Phone (337) 513-6121

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1472169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679875200000",
    "number": "1457807828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2789 CROWN LN",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706058135",
            "telephone_number": "337-491-3793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 ALAMO ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706018528",
            "telephone_number": "337-513-6121",
            "fax_number": "877-794-0365"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2789 Crown Ln",
            "address_purpose": "LOCATION",
            "city": "Lake Charles",
            "state": "LA",
            "postal_code": "706058135",
            "country_code": "US",
            "telephone_number": "337-491-3793",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOYD",
        "first_name": "STEPHANIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-26",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "LA",
            "license": "1395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2023; 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.