Lisa Broadnax, MED

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

6351 Main St
Zachary, LA 70791-4038

Phone

(225) 306-2000

Fax

(225) 658-1282

NPI assigned

Mar 21, 2018

Last updated

Mar 21, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Lisa Broadnax-Jackson Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

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

{
    "created_epoch": "1521590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521590400000",
    "number": "1508360777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 770",
            "city": "ZACHARY",
            "state": "LA",
            "postal_code": "707910770",
            "telephone_number": "225-306-2000",
            "fax_number": "225-658-1282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6351 MAIN ST",
            "city": "ZACHARY",
            "state": "LA",
            "postal_code": "707914038",
            "telephone_number": "225-306-2000",
            "fax_number": "225-658-1282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROADNAX",
        "first_name": "LISA",
        "credential": "MED",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-21",
        "last_updated": "2018-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "BROADNAX-JACKSON",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Addiction (Substance Use Disorder) Counselor in Zachary, LA
• Providers in Zachary, LA by specialty
• Addiction (Substance Use Disorder) Counselor in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2018; 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.