Active NPI
Skyi Vincent Bordelon, LPC
- Counselor
- Lafayette, LA
National Provider Identifier
1467916072
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 4664
- Practice address
- 216 Acorn Dr
Lafayette, LA 70507-4204 - Phone
- (337) 501-6175
- NPI assigned
- Jan 28, 2019
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 4664 | LA | Primary |
Addresses
Primary practice location
216 Acorn Dr
Lafayette, LA 70507-4204
Mailing address
216 Acorn Dr
Lafayette, LA 70507-4204
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4664 | Other | LA | LPC BOARD OF EXAMINERS |
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 |
|---|---|---|---|
| 4664 | LA | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1548633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548633600000",
"number": "1467916072",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "216 ACORN DR",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "705074204"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "216 ACORN DR",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "705074204",
"telephone_number": "337-501-6175"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BORDELON",
"first_name": "SKYI",
"middle_name": "VINCENT",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-01-28",
"last_updated": "2019-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor",
"state": "LA",
"license": "4664",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LPC BOARD OF EXAMINERS",
"identifier": "4664",
"state": "LA"
}
],
"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 Jan 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.