Active NPI
Taylor Boulet Frederick
- Behavior Analyst
- Lafayette, LA
National Provider Identifier
1740897719
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- L-478
- Practice address
- 123 Westmark Blvd
Lafayette, LA 70506-7345 - Phone
- (337) 255-0950
- Fax
- (337) 466-2296
- NPI assigned
- Sep 24, 2020
- 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 | L-478 | LA | Primary |
Addresses
Primary practice location
123 Westmark Blvd
Lafayette, LA 70506-7345
Mailing address
123 Westmark Blvd
Lafayette, LA 70506-7345
Phone (337) 255-0950
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 |
|---|---|---|---|
| L-478 | LA | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1600905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706572800000",
"number": "1740897719",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "123 WESTMARK BLVD",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "705067345",
"telephone_number": "337-255-0950",
"fax_number": "337-466-2296"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "123 WESTMARK BLVD",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "705067345",
"telephone_number": "337-255-0950",
"fax_number": "337-466-2296"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREDERICK",
"first_name": "TAYLOR",
"middle_name": "BOULET",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-09-24",
"last_updated": "2024-01-30",
"certification_date": "2024-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "LA",
"license": "L-478",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lafayette, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.