Christina Speyrer Thibodeaux, L.P.C., L.M.F.T.
Individual provider Active NPI Mental Health Counselor · Lafayette, LA
NPI 1922497734 · NPPES record last updated Aug 12, 2024
Key facts
- NPI
- 1922497734
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 4540 (LA)
- Practice address
- 1405 W Pinhook Rd Ste 108a
Lafayette, LA 70503-3100 - Phone
- (337) 849-0019
- Fax
- (337) 234-4038
- NPI assigned
- Jan 16, 2015
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1405 W Pinhook Rd
Suite 108a
Lafayette, LA 70503-3100
Phone (337) 849-0019
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 |
|---|---|---|---|---|
| I20250114000332 | LA | Practitioner - Mental Health Counselor | 6305374711 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P1611170 | AR | MD | Mental Health Counselor |
| 0701006026 | VA | MD | Mental Health Counselor |
| 4540 | LA | MD | Clinical Social Worker |
| 1150 | LA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Christina Thibodeaux, LPC LTD | Current |
Accepting new patients | |
| River Valley Psychology PLLC | Past | Accepting new patients |
Locations
1405 W Pinhook Rd
Ste 108A
Lafayette, LA 70503
Phone (337) 849-0019
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 0701006026 | VA | |
| Mental Health Counselor | 101YM0800X | P1611170 | AR | |
| Mental Health Counselor | 101YM0800X | 4540 | LA | Yes |
| Marriage & Family Therapist | 106H00000X | 1150 | LA |
Addresses
Primary practice location
1405 W Pinhook Rd Ste 108a
Lafayette, LA 70503-3100
Mailing address
110 Sheridan Dr.
Lafayette, LA 70506
Phone (337) 849-0019
Other names
- Ms. Christina Speyrer
Other providers in Lafayette, LA
- Anthony Collins Thibodeaux
- Brett Michael Thibodeaux
- Brittin Thibodeaux
- Catherine Thibodeaux
- Celia Marie Thibodeaux
- Dakota Thibodeaux
- Dana Lynn Thibodeaux
- Darline Marie Thibodeaux
- Elizabeth C Thibodeaux
- Jeffrey J Thibodeaux
All providers in Lafayette, LA · Mental Health Counselor in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 12, 2024. 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.