Active NPI
Danielle Boudreaux, BCBA, LBA
- Behavior Analyst
- Baton Rouge, LA
National Provider Identifier
1679073365
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 468
- Practice address
- 9063 Siegen LN Ste a
Baton Rouge, LA 70810-2051 - Phone
- (225) 294-1600
- NPI assigned
- Feb 19, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 468 | LA | Primary |
Addresses
Primary practice location
9063 Siegen LN Ste a
Baton Rouge, LA 70810-2051
Mailing address
13612 Shady Ridge Ave
Baton Rouge, LA 70817-2843
Phone (225) 892-5943
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 468 | LA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Behavioral Health | Behavior Analyst | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Behavior Analyst
- Baton Rouge, LA
- NPI 1124744057
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1518998400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597622400000",
"number": "1679073365",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13612 SHADY RIDGE AVE",
"city": "BATON ROUGE",
"state": "LA",
"postal_code": "708172843",
"telephone_number": "225-892-5943"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9063 SIEGEN LN STE A",
"city": "BATON ROUGE",
"state": "LA",
"postal_code": "708102051",
"telephone_number": "225-294-1600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOUDREAUX",
"first_name": "DANIELLE",
"credential": "BCBA, LBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-19",
"last_updated": "2020-08-17",
"certification_date": "2020-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "LA",
"license": "468",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baton Rouge, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.