Individual provider Active NPI

Kortney Broussard Chevalier, LPC-S

  • Professional Counselor
  • Lafayette, LA
National Provider Identifier
1609269992
Registry record updated Nov 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
5313 Issued in LA
Practice address
1011 Harding St
Lafayette, LA 70503
Phone
(337) 591-7563
Fax
(337) 247-9706
NPI assigned
Mar 10, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 5313 LA
Professional Counselor 101YP2500X 5313 LA Primary

Addresses

Primary practice location

1011 Harding St
Lafayette, LA 70503

Mailing address

208 Devon Way
Youngsville, LA 70592-5473
Phone (337) 591-7563

Other practice location 1

212 Guilbeau Rd
Lafayette, LA 70506-6141
Phone (337) 591-7563

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

LicenseStateTypeSpecialty
5313LAMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Inspirational Community Outreach LLC Current Accepting new patients
Kortneys Kounseling Services, LLC Professional CurrentSince Nov 17, 2019 Accepting new patients
Essential Care Services, LLC Past Accepting new patients

Locations

1011 Harding St
Lafayette, LA 70503
Phone (337) 591-7563

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1425945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573603200000",
    "number": "1609269992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 DEVON WAY",
            "city": "YOUNGSVILLE",
            "state": "LA",
            "postal_code": "705925473",
            "telephone_number": "337-591-7563",
            "fax_number": "337-247-9706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 HARDING ST",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "70503",
            "telephone_number": "337-591-7563",
            "fax_number": "337-247-9706"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "212 Guilbeau Rd",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "LA",
            "postal_code": "705066141",
            "country_code": "US",
            "telephone_number": "337-591-7563",
            "fax_number": "888-821-4205",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHEVALIER",
        "first_name": "KORTNEY",
        "middle_name": "BROUSSARD",
        "credential": "LPC-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-10",
        "last_updated": "2019-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "LA",
            "license": "5313",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "LA",
            "license": "5313",
            "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 Nov 13, 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.

Verify at the official NPI Registry.