The Neutral Ground Collective

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

THE NEUTRAL GROUND COLLECTIVE

Practice address

4035 Washington Ave
New Orleans, LA 70125-2935

Phone

(435) 491-0561

NPI assigned

Jun 30, 2021

Organization subpart

No

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

Authorized official

Name

Mark Broussard, LCSW

Title

Clinic Manager

Phone

(435) 491-0531

Specialties & licenses 1

Addresses

Other names 1

• Neutral Ground Collective Doing business as

Electronic endpoints 1

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

{
    "created_epoch": "1625011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660176000000",
    "number": "1467022533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4035 WASHINGTON AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701252935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4035 WASHINGTON AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701252935",
            "telephone_number": "435-491-0561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE NEUTRAL GROUND COLLECTIVE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-30",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A",
        "authorized_official_last_name": "BROUSSARD",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CLINIC MANAGER",
        "authorized_official_telephone_number": "435-491-0531",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "mrb@tngcollective.com",
            "affiliation": "N",
            "address_1": "4035 Washington Ave",
            "city": "New Orleans",
            "state": "LA",
            "country_code": "US",
            "postal_code": "701252935",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Neutral Ground Collective",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Neutral Ground Collective",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinical Social Worker in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 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.

Verify at the official NPI Registry.