NPIMap

Organization Active NPI

Beauregard Behavioral Health Clinic

  • Clinic/Center
  • Deridder, LA
National Provider Identifier
1629319223
Registry record updated Mar 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
BEAUREGARD BEHAVIORAL HEALTH CLINIC
Practice address
106 W Port St
Deridder, LA 70634-4040
Phone
(337) 462-1641
NPI assigned
Mar 6, 2013
Last updated
Mar 6, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2013

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

Authorized official

Name
Mrs. Natha Gantt, LCSWNPI 1477691699
Title
Clinic Manager
Phone
(337) 462-1641

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

106 W Port St
Deridder, LA 70634-4040

Mailing address

106 W Port St
Deridder, LA 70634-4040
Phone (337) 462-1641

National Provider Directory

National Provider Directory
Tax ID family
Shamrock Street Pharmacy11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1362528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362528000000",
    "number": "1629319223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 W PORT ST",
            "city": "DERIDDER",
            "state": "LA",
            "postal_code": "706344040",
            "telephone_number": "337-462-1641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 W PORT ST",
            "city": "DERIDDER",
            "state": "LA",
            "postal_code": "706344040",
            "telephone_number": "337-462-1641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAUREGARD BEHAVIORAL HEALTH CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-06",
        "last_updated": "2013-03-06",
        "status": "A",
        "authorized_official_last_name": "GANTT",
        "authorized_official_first_name": "NATHA",
        "authorized_official_title_or_position": "CLINIC MANAGER",
        "authorized_official_telephone_number": "337-462-1641",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deridder, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2013; 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.