NPIMap

Organization Active NPI

Mental Connections of Southwest LLC

  • Mental Health Counselor
  • Lake Charles, LA
National Provider Identifier
1508301037
Registry record updated Apr 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
4894 Issued in LA
Legal business name
MENTAL CONNECTIONS OF SOUTHWEST LLC
Practice address
127 Williamsburg St BLDG E
Lake Charles, LA 70605-5719
Phone
(337) 376-0136
Fax
(337) 376-5244
NPI assigned
Dec 19, 2016
Last updated
Apr 5, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2021

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

Authorized official

Name
Ms. Robin Claire Daugereau, LPCNPI 1063857191
Title
Owner/Manager
Phone
(337) 376-0136

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YM0800X 4894 LA Primary

Addresses

Primary practice location

127 Williamsburg St BLDG E
Lake Charles, LA 70605-5719

Mailing address

PO Box 1273
Lake Charles, LA 70602-1273
Phone (337) 376-0136

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210817000981 LA Part B Supplier - Clinic/Group Practice 1850796632 Receives reassigned benefits from 5 practitioners
Practice locations: Lake Charles, LA

National Provider Directory

National Provider Directory

Locations

127 Williamsburg St
Bldg E
Lake Charles, LA 70605
Phone (337) 376-0136

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1482105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617580800000",
    "number": "1508301037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1273",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706021273",
            "telephone_number": "337-376-0136",
            "fax_number": "337-376-5244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 WILLIAMSBURG ST BLDG E",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706055719",
            "telephone_number": "337-376-0136",
            "fax_number": "337-376-5244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENTAL CONNECTIONS OF SOUTHWEST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-19",
        "last_updated": "2021-04-05",
        "certification_date": "2021-04-05",
        "status": "A",
        "authorized_official_last_name": "DAUGEREAU",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_middle_name": "CLAIRE",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "337-376-0136",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "LA",
            "license": "4894",
            "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 Apr 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.