Individual provider Active NPI

Robert J Brankline Jr.

  • Mental Health Counselor
  • Gonzales, LA
National Provider Identifier
1629651195
Registry record updated May 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
43043 Pelican Lakes CT
Gonzales, LA 70737-8578
Phone
(225) 337-5254
NPI assigned
May 3, 2021
Last updated
May 3, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

43043 Pelican Lakes CT
Gonzales, LA 70737-8578

Mailing address

41452 Creekstone Ave
Prairieville, LA 70769-5787
Phone (225) 337-5254

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1620000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620000000000",
    "number": "1629651195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41452 CREEKSTONE AVE",
            "city": "PRAIRIEVILLE",
            "state": "LA",
            "postal_code": "707695787",
            "telephone_number": "225-337-5254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43043 PELICAN LAKES CT",
            "city": "GONZALES",
            "state": "LA",
            "postal_code": "707378578",
            "telephone_number": "225-337-5254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANKLINE",
        "first_name": "ROBERT",
        "middle_name": "J",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-03",
        "last_updated": "2021-05-03",
        "certification_date": "2021-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gonzales, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2021; 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.