Jason C Fanguy, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

8752 Issued in LA

Practice address

235 Civic Center Blvd
Houma, LA 70360-5937

Phone

(985) 333-2020

NPI assigned

Mar 16, 2016

Last updated

Oct 3, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Interoperability endpoints

• Direct secure messaging: jasonfanguy@tdh.allscriptsdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Mental Health

  NPD

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

{
    "created_epoch": "1458086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1538520796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3398 BROOKWOOD DR",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703607297",
            "telephone_number": "985-856-2990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 CIVIC CENTER BLVD",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703605937",
            "telephone_number": "985-333-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANGUY, LPC",
        "first_name": "JASON",
        "middle_name": "C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-03-16",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "LA",
            "license": "8752",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED PROFESSIONAL COUNSELOR LICENSE #8752",
            "identifier": "8752",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Family Chiropractic Center
• Family Doctor Clinic Apmc
• Family Foot Clinic, PMC
• Family Vision Clinic Inc
• Heather Lynn Fanguy, F.N.P.
• Nikki Fanguy, LPC
• Michael Christopher Farmer, RN
• Nancy T Faucheaux, NP
• Katie Faulk, OTD
• Louise Breaux Fazzio, SLP

• Professional Counselor in Houma, LA
• Providers in Houma, LA by specialty
• Professional Counselor in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2023; 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.