NPIMap

Organization Active NPI

Jennings Behavioral Health, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Sulphur, LA
National Provider Identifier
1891947479
Registry record updated Oct 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP 05359 Issued in LA
Legal business name
JENNINGS BEHAVIORAL HEALTH, LLC
Practice address
110 E Darbonne St
Sulphur, LA 70663-4958
Phone
(337) 527-7878
Fax
(337) 527-7880
NPI assigned
Oct 15, 2008
Last updated
Oct 15, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2008

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

Authorized official

Name
Mrs. Stacy Gaudet
Title
MGR Sulphur Outpatient Clinic
Phone
(337) 527-7878

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP 05359 LA Primary
Psychologist 103T00000X 1055 LA
Clinical Social Worker 1041C0700X 8971 LA
Psychiatry Physician 2084P0800X 021615 LA
General Practice Physician 208D00000X 014484R LA

Addresses

Primary practice location

110 E Darbonne St
Sulphur, LA 70663-4958

Mailing address

110 E Darbonne St
Sulphur, LA 70663-4958
Phone (337) 527-7878

Other identifiers 2

IdentifierTypeStateIssuer
1949744MedicaidLA
5C425OtherLAMEDICARE

National Provider Directory

National Provider Directory
Tax ID family
JBH Sulphur Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1224028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224028800000",
    "number": "1891947479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 E DARBONNE ST",
            "city": "SULPHUR",
            "state": "LA",
            "postal_code": "706634958",
            "telephone_number": "337-527-7878",
            "fax_number": "337-527-7880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E DARBONNE ST",
            "city": "SULPHUR",
            "state": "LA",
            "postal_code": "706634958",
            "telephone_number": "337-527-7878",
            "fax_number": "337-527-7880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNINGS BEHAVIORAL HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-15",
        "last_updated": "2008-10-15",
        "status": "A",
        "authorized_official_last_name": "GAUDET",
        "authorized_official_first_name": "STACY",
        "authorized_official_title_or_position": "MGR SULPHUR OUTPATIENT CLINIC",
        "authorized_official_telephone_number": "337-527-7878",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "LA",
            "license": "AP 05359",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "LA",
            "license": "1055",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "8971",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "LA",
            "license": "021615",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "LA",
            "license": "014484R",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1949744",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "5C425",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sulphur, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2008; 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.