Chalayne Deville Beaubouef, LCSW
Individual provider Active NPI Clinical Social Worker · Deville, LA
NPI 1801261656 · NPPES record last updated Sep 10, 2018
Key facts
- NPI
- 1801261656
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 9772 (LA)
- Practice address
- 715 Highway 1207
Deville, LA 71328-8505 - Phone
- (318) 466-8335
- Fax
- (318) 466-8338
- NPI assigned
- Dec 4, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 7
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Minor Med Care, LLC
MDB Behavioral Health Services LLC
Practice addresses (Care Compare)
120 W Main St
Raymond, MS 39154-1223
Phone (601) 857-2341
1911 Mission
66 Suite B
Vicksburg, MS 39180-3762
Phone (601) 456-2598
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251028000710 | LA | Practitioner - Clinical Social Worker | 1658860929 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9772 | LA | MD | School Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Complete Care of St Gabriel LLC | Current |
Accepting new patients | |
| Access Health Louisiana | Past | Accepting new patients | |
| Access Health Louisiana | Past |
Accepting new patients |
Locations
735 Highway 30
Bldg 1
Saint Gabriel, LA 70776
Phone (225) 314-9314
215 Katherine Dr
#A
Jackson, MS 39232
Interoperability endpoints
- chalayne.beaubouef.1@11331.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Social Worker | 1041S0200X | 9772 | LA | |
| Clinical Social Worker | 1041C0700X | 9772 | LA | Yes |
Addresses
Primary practice location
715 Highway 1207
Deville, LA 71328-8505
Mailing address
331 Beaubouef Rd
Deville, LA 71328-9767
Phone (318) 664-9442
Other providers in Deville, LA
- Access Health Louisiana
- Ross Alan Babb
- Kimberly Belgard
- Alex Cauley
- Cenla Mental Health LLC
- Cenla Speech Language Therapy LLC
- Christus Health Central Louisiana
All providers in Deville, LA · Clinical Social Worker in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 10, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.