Organization Active NPI

Bayou Roots Integrated Care

  • Psychiatry Physician
  • Lake Charles, LA
National Provider Identifier
1720990047
Registry record updated Sep 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
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, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2026

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)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 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.

Verify at the official NPI Registry.