MMT Therapy and Wellness

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

MMT THERAPY AND WELLNESS

Practice address

814 Fortune Rd Ste 108
Youngsville, LA 70592-5542

Phone

(337) 513-0822

Fax

(337) 202-2376

NPI assigned

Apr 11, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Michele ThibodeauxNPI 1992443469

Title

LCSW

Phone

(337) 501-8697

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michele M Thibodeaux, LCSW-BACS

  • Clinical Social Worker
  • Abbeville, LA
  • NPI 1992443469
  Medicare reassignment NPD Authorized official
• Stephanie Ann McCurdy, FNP

  • Family Nurse Practitioner
  • Cambridge, OH
  • NPI 1316511082
  NPD (past)

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

{
    "created_epoch": "1681171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695772800000",
    "number": "1841985173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8448 STEVE RD",
            "city": "KAPLAN",
            "state": "LA",
            "postal_code": "705486437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "814 FORTUNE RD STE 108",
            "city": "YOUNGSVILLE",
            "state": "LA",
            "postal_code": "705925542",
            "telephone_number": "337-513-0822",
            "fax_number": "337-202-2376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MMT THERAPY AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-11",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A",
        "authorized_official_last_name": "THIBODEAUX",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_title_or_position": "LCSW",
        "authorized_official_telephone_number": "337-501-8697"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julianne Mestayer
• Tanisha Daniele Middleton
• Tyler Bartholomew Miller, FNP-C
• Kaylan Elizabeth Mitchell
• Trelles Mitchell
• Mobility Products Depot
• Mobility Products Depot
• Mobility Products Depot
• Mobility Products Depot LLC
• Brooklyn Grace Money

• Clinical Social Worker in Youngsville, LA
• Providers in Youngsville, LA by specialty
• Clinical Social Worker in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.