MR. CODY PAUL BROUSSARD (NPI# 1467977488) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467977488 |
| Entity Type | Individual |
| Full Name | MR. CODY PAUL BROUSSARD |
| Credential | PLPC |
| Practice Address |
203 E Academy Ave Jennings LA 70546 |
| Mailing Address |
203 E Academy Ave Jennings LA 70546-5331 |
| Practice Telephone | (337) 824-1255 |
| Mailing Telephone | 3378241255 |
| Enumeration Date | 2017-08-10 |
| Last Update Date | 2018-08-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 104100000X | Social Worker | Behavioral Health & Social Service Providers | ||
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| Street Address |
203 E ACADEMY AVE |
| City | JENNINGS |
| State | LA |
| Zip Code | 70546 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275906372 | Elizabeth Marie Ogea | Counselor | 203 E Academy Ave, Jennings, LA 70546 | 2015-11-11 |
| 1578127775 | Andre A Malbrough | Case Manager/Care Coordinator | 203 E Academy Ave, Jennings, LA 70546-5331 | 2019-04-24 |
| 1356806780 | Jordan Christopher Owens | Case Manager/Care Coordinator | 203 E Academy Ave, Jennings, LA 70546-5331 | 2019-02-11 |
| 1912403213 | Heather Dawn Herpin | Counselor | 203 E Academy Ave, Jennings, LA 70546 | 2018-04-04 |
| 1255852794 | Jamie Lynn Hebert | Behavioral Analyst | 203 E Academy Ave, Jennings, LA 70546-5331 | 2017-07-06 |
| 1023559879 | Kelly Saunier | Counselor | 203 E Academy Ave, Jennings, LA 70546-5331 | 2017-03-13 |
| 1861932188 | Mattie Morgan | Counselor | 203 E Academy Ave, Jennings, LA 70546-5331 | 2017-03-06 |
| 1659815058 | Dylan Trahan | Counselor | 203 E Academy Ave, Jennings, LA 70546-5331 | 2016-12-05 |
| 1871035311 | Janisa Leann Jackson | Counselor | 203 E Academy Ave, Second Level Suites, Jennings, LA 70546-5331 | 2016-11-15 |
| 1912457441 | Kateshia Levi | Case Manager/Care Coordinator | 203 E Academy Ave, Jennings, LA 70546 | 2016-10-07 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295374593 | Skye Ringuet | Assistant Behavior Analyst | 611 North State St., Jennings, LA 70546 | 2020-01-03 |
| 1588120612 | Southern Home Care Services, Inc | Technician | 233 N. Main St., Jennings, LA 70546 | 2019-02-13 |
| 1902399249 | Calcasieu Urgent Care LLC | Clinic/Center | 1750 Elton Rd, Jennings, LA 70546 | 2018-06-12 |
| 1407308489 | Jefferson Davis Parish Council On Aging | Non-emergency Medical Transport (VAN) | 210 South State Street, Jennings, LA 70546 | 2016-10-26 |
| 1225401706 | Taylor Farris | Counselor | 1615 Johnston Street, Suite C, Jennings, LA 70546 | 2015-11-05 |
| 1134595622 | Karen Lynn Golla | Nurse Practitioner | 422 Kade Dr Ste 1, Jennings, LA 70546 | 2015-08-19 |
| 1326301615 | Lisa Turner | Registered Nurse | 403 Baker Street, Jennings, LA 70546 | 2012-06-21 |
| 1790057149 | Cenikor Foundation | Counselor | 222 E Academy, Suite A, Jennings, LA 70546 | 2012-02-01 |
| 1821328642 | Eric P Lambousy | Physical Therapist | 1322 Elton Road, Suite I, Jennings, LA 70546 | 2009-12-29 |
| 1124248968 | Shane Taylor Wilkinson | Chiropractor | 1607 Johnson St., Jennings, LA 70546 | 2007-04-26 |
| Find all providers in zip 70546 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013528645 | April Joseph | Case Manager/Care Coordinator | 1615 Johnson St, Jennings, LA 70546-3650 | 2020-08-17 |
| 1649880782 | Sharika Laws | Case Manager/Care Coordinator | 1615 Johnson St, Jennings, LA 70546-3650 | 2020-08-04 |
| 1467074948 | Megan Cole | Case Manager/Care Coordinator | 1615 Johnson St, Jennings, LA 70546-3650 | 2020-05-07 |
| 1326686627 | Kiala Singleton | Case Manager/Care Coordinator | 1615 Johnson St Ste C, Jennings, LA 70546-3650 | 2019-12-17 |
| 1861054728 | Yolanda Poullard | Case Manager/Care Coordinator | 1615 Johnson St Ste C, Jennings, LA 70546-3650 | 2019-07-01 |
| 1710546981 | Kadesia D Harmon | Case Manager/Care Coordinator | 1615 Johnson St, Jennings, LA 70546-3650 | 2019-06-11 |
| 1730747007 | Christopher Daniel Harford | Case Manager/Care Coordinator | 1615 Johnson St, Jennings, LA 70546-3650 | 2019-06-03 |
| 1578127775 | Andre A Malbrough | Case Manager/Care Coordinator | 203 E Academy Ave, Jennings, LA 70546-5331 | 2019-04-24 |
| 1356806780 | Jordan Christopher Owens | Case Manager/Care Coordinator | 203 E Academy Ave, Jennings, LA 70546-5331 | 2019-02-11 |
| 1780169615 | Cirstie Beaubouef | Case Manager/Care Coordinator | 1615 Johnson St, Jennings, LA 70546-3650 | 2018-09-26 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.