Kelsey Broussard

Primary specialty

CounselorTaxonomy code 101Y00000X

License

90665 Issued in TX

Practice address

2225 County Road 90 Ste 105
Pearland, TX 77584-4891

Phone

(979) 285-9242

NPI assigned

Mar 28, 2024

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lemon Frazier Psychological Services

  • Clinical Psychologist
  • Lake Jackson, TX
  • NPI 1023462314
  NPD (past)

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

{
    "created_epoch": "1711584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711584000000",
    "number": "1831940915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2225 COUNTY ROAD 90 STE 105",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775844891",
            "telephone_number": "979-285-9242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2225 COUNTY ROAD 90 STE 105",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775844891",
            "telephone_number": "979-285-9242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUSSARD",
        "first_name": "KELSEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-28",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TX",
            "license": "90665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Michelle Brock, LPC
• Jessica Brogdon
• Sheila Brose
• Kristine Korn Broughton, MA, CCC-SLP
• Breana Broussard
• Tellis D Broussard, D.C
• Ariel Jenai Brown
• Brittane Brown, LMT
• Christopher Wayne Brown, MA, LPC, LPCI
• Heather Brown

• Counselor in Pearland, TX
• Providers in Pearland, TX by specialty
• Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 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.

Verify at the official NPI Registry.