Active NPI
Jessica Broussard Baudoin, PH.D., LMFT, LPC
- Marriage & Family Therapist
- Lafayette, LA
National Provider Identifier
1861794729
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 1138
- Practice address
- 4540 Ambassador Caffery Pkwy
Building D, Suite B-220
Lafayette, LA 70508-6928 - Phone
- (337) 981-2180
- Fax
- (337) 981-2391
- NPI assigned
- Nov 29, 2010
- Last updated
- Nov 29, 2010
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 1138 | LA | Primary |
| Counselor | 101Y00000X | 4042 | LA |
Addresses
Primary practice location
4540 Ambassador Caffery Pkwy
Building D, Suite B-220
Lafayette, LA 70508-6928
Mailing address
3936 Olias Rd
Erath, LA 70533-6351
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1138 | LA | MD | Marriage & Family Therapist |
| 4042 | LA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1290988800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1290988800000",
"number": "1861794729",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3936 OLIAS RD",
"city": "ERATH",
"state": "LA",
"postal_code": "705336351"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4540 AMBASSADOR CAFFERY PKWY",
"address_2": "BUILDING D, SUITE B-220",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "705086928",
"telephone_number": "337-981-2180",
"fax_number": "337-981-2391"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAUDOIN",
"first_name": "JESSICA",
"middle_name": "BROUSSARD",
"credential": "PH.D., LMFT, LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-11-29",
"last_updated": "2010-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "LA",
"license": "1138",
"primary": true
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "LA",
"license": "4042",
"primary": false
}
],
"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 Nov 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.