Active NPI
Rachel Lacy Broussard, LCSW
- Clinical Social Worker
- Lafayette, LA
National Provider Identifier
1497220727
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 8721
- Practice address
- 200 La Rue France Ste 102
Lafayette, LA 70508-3104 - Phone
- (337) 781-4389
- Fax
- (855) 299-0797
- NPI assigned
- Oct 13, 2018
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 8721 | LA | Primary |
Addresses
Primary practice location
200 La Rue France Ste 102
Lafayette, LA 70508-3104
Mailing address
200 La Rue France Ste 102
Lafayette, LA 70508-3104
Phone (337) 781-4389
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8721 | LA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1539388800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557360000000",
"number": "1497220727",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 LA RUE FRANCE STE 102",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "705083104",
"telephone_number": "337-781-4389",
"fax_number": "855-299-0797"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 LA RUE FRANCE STE 102",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "705083104",
"telephone_number": "337-781-4389",
"fax_number": "855-299-0797"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROUSSARD",
"first_name": "RACHEL",
"middle_name": "LACY",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-10-13",
"last_updated": "2019-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": "LA",
"license": "8721",
"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 May 9, 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.