Melissa Randall Broussard, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

10573 Issued in LA

Practice address

8585 Picardy Ave
Baton Rouge, LA 70809-3748

Phone

(225) 763-4867

NPI assigned

Nov 30, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1512000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512000000000",
    "number": "1679087571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18348 THREE BARS DR",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708170707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8585 PICARDY AVE",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708093748",
            "telephone_number": "225-763-4867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUSSARD",
        "first_name": "MELISSA",
        "middle_name": "RANDALL",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-30",
        "last_updated": "2017-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "10573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristy Smith Broussard, NNP
• Lauren Causey Broussard, NP
• Malcolm J Broussard
• Mark Shannon Broussard, LAC, CCS
• Martha A Broussard, CRNA
• Morgan Bankston Broussard, M.D.
• Peggy Broussard, LPC
• Ranisa Washington Broussard
• Ryan Chase Broussard, PHARMD
• Shelby Broussard

• Clinical Social Worker in Baton Rouge, LA
• Providers in Baton Rouge, LA by specialty
• Clinical Social Worker in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2017; 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.