Active NPI
Bayou Roots Integrated Care
- Psychiatry Physician
- Lake Charles, LA
National Provider Identifier
1720990047
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- Legal business name
- BAYOU ROOTS INTEGRATED CARE
- Practice address
- 3714 Louisiana Ave
Lake Charles, LA 70607-3044 - Phone
- (337) 391-9976
- NPI assigned
- Sep 21, 2026
- Last updated
- Sep 21, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ashley Antionette Montgomery, PMHNP-BC
- Title
- Owner
- Phone
- (337) 391-9976
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | Primary |
Addresses
Primary practice location
3714 Louisiana Ave
Lake Charles, LA 70607-3044
Mailing address
PO Box 143
Lake Charles, LA 70602-0143
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1789948800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1789948800000",
"number": "1720990047",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 143",
"city": "LAKE CHARLES",
"state": "LA",
"postal_code": "706020143"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3714 LOUISIANA AVE",
"city": "LAKE CHARLES",
"state": "LA",
"postal_code": "706073044",
"telephone_number": "337-391-9976"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BAYOU ROOTS INTEGRATED CARE",
"organizational_subpart": "NO",
"enumeration_date": "2026-09-21",
"last_updated": "2026-09-21",
"certification_date": "2026-09-21",
"status": "A",
"authorized_official_last_name": "MONTGOMERY",
"authorized_official_first_name": "ASHLEY",
"authorized_official_middle_name": "ANTIONETTE",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "337-391-9976",
"authorized_official_credential": "PMHNP-BC"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lake Charles, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.