GULF SOUTH BR - ABA, LLC (NPI# 1871089763) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871089763 |
| Entity Type | Organization |
| Organization Name | GULF SOUTH BR - ABA, LLC |
| Practice Address |
9063 Siegen Ln Ste A Baton Rouge LA 70810 |
| Mailing Address |
2901 N I 10 Service Rd E Ste 300 Metairie LA 70002-6137 |
| Practice Telephone | 5047801702 |
| Mailing Telephone | 5047801702 |
| Mailing Fax Number | 5047801705 |
| Enumeration Date | 2018-07-03 |
| Last Update Date | 2018-07-26 |
| Authorized Official Name | KEVIN J BIANCHINI (MANAGING MEMBER) |
| Authorized Official Telephone | 5047801702 |
| Authorized Official Credential | PH.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
Behavioral Health & Social Service Providers |
| Street Address |
9063 SIEGEN LN STE A |
| City | BATON ROUGE |
| State | LA |
| Zip Code | 70810 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679073365 | Danielle Boudreaux | Behavioral Analyst | 9063 Siegen Ln Ste A, Baton Rouge, LA 70810-2051 | 2018-02-19 |
| 1417500596 | Jada Sanders | Behavior Technician | 9063 Siegen Ln Ste A, Baton Rouge, LA 70810-2051 | 2019-07-18 |
| 1760953756 | Aubree Hart | Speech-Language Pathologist | 9063 Siegen Ln Ste A, Baton Rouge, LA 70810-2051 | 2018-12-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639734973 | Baton Rouge Clinic, A Medical Corporation | Podiatrist | 8160 Ymca Blvd, Suite C, Baton Rouge, LA 70810 | 2019-05-02 |
| 1699278135 | Taylor Denise Debourg | Specialist/Technologist | 8921 Boone Drive, Baton Rouge, LA 70810 | 2018-03-12 |
| 1528583945 | Baton Rouge Perio, L.L.C. | Dentist | 10723 N. Oak Hills Parkway, Bldg. B, Baton Rouge, LA 70810 | 2017-08-07 |
| 1902334931 | Reginald Shaffer | Counselor | 13621 Kenner Ave Apt C, Baton Rouge, LA 70810 | 2017-06-03 |
| 1770010381 | Keona Julien | Case Manager/Care Coordinator | 9270 Siegen Ln Suite 101, Baton Rouge, LA 70810 | 2017-05-12 |
| 1205372893 | Grand Canyon Mobile Dentistry | Dentist | 8480 Bluebonnet Blvd Ste E, Baton Rouge, LA 70810 | 2017-01-06 |
| 1215395173 | Kimberly Booker | Counselor | 9371 Bimini Dr, Baton Rouge, LA 70810 | 2016-02-08 |
| 1710354022 | St Gabriel Health Clinic, Inc | Clinic/Center | 9211 Parkway Dr, Baton Rouge, LA 70810 | 2015-08-24 |
| 1942682430 | Jasmine Alexander | Counselor | 9270 Siegen Ln Bldg 101, Baton Rouge, LA 70810 | 2015-06-22 |
| 1073991535 | James Michael Robinson | Family Medicine | 12525 Perkins Rd Ste A, Baton Rouge, LA 70810 | 2015-05-15 |
| Find all providers in zip 70810 | ||||
| Taxonomy Code | 103TC2200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical Child & Adolescent |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982830790 | Karen R. Sheridan | Psychologist | 4615 Government St, Baton Rouge, LA 70806-5922 | 2009-06-08 |
| 1467691303 | James A Vanhook | Psychologist | 4615 Government St, Bldg 1, Baton Rouge, LA 70806-5820 | 2009-02-17 |
| 1841452810 | Derek L White | Psychologist | 4615 Government St, Building 2, Baton Rouge, LA 70806-5820 | 2008-06-30 |
| 1073712618 | Bianchini-frey, LLC | Psychologist | 9118 Bluebonnet Centre Blvd, Baton Rouge, LA 70809-2975 | 2007-07-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750928693 | Adrianne M Brennan Phd | Psychologist | 110 James Dr W, Saint Rose, LA 70087-4027 | 2019-12-10 |
| 1972758639 | Adrianne M Brennan | Psychologist | 433 Metairie Rd Ste 615, Metairie, LA 70005-4326 | 2008-11-22 |
| 1760647663 | William E Fowler | Psychologist | 309 Crystal St, New Orleans, LA 70124-2619 | 2008-07-21 |
| 1598926644 | Jerald W Bamburg Jr. | Psychologist | 106 N Bend Dr, Pineville, LA 71360-4677 | 2008-06-20 |
| 1548456189 | Courtney N. Baker | Psychologist | 6400 Freret St, Psychology Dept., 2007 Percival Stern Hall, New Orleans, LA 70118-5636 | 2007-09-18 |
| 1497895262 | Mercy Family Center | Psychologist | 110 Veterans Memorial Blvd., Suite 425, Metairie, LA 70005-4959 | 2007-02-08 |
| 1447310289 | Peter Clark | Psychologist | 203 W 21st Ave, Covington, LA 70433-3151 | 2006-12-11 |
| 1063473213 | Claire Dianne Peebles | Psychologist | 4517 Lorino St, Metairie, LA 70006-2323 | 2006-03-29 |
| 1831750645 | Kasia Plessy | Psychologist | 1430 Tulane Ave # 8055, New Orleans, LA 70112-2632 | 2019-06-23 |
| 1114588142 | Jamil Monique Gilliam | Psychologist | 1430 Tulane Ave # 8055, New Orleans, LA 70112-2632 | 2019-06-20 |
| Find all providers with the same taxonomy | ||||
| City | BATON ROUGE |
| Zip Code | 70810 |
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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.