JOSEPH KENNETH BROUSSARD MATS NPI 1326405887

NPI Information

NPI: 1326405887
Provider Name: JOSEPH KENNETH BROUSSARD, MATS
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

CLIA Number: 15D0671957

Address:
7509 CHARLESTOWN PIKE
CHARLESTOWN, IN
ZIP 47111
Phone: (812) 256-4686
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Joseph Kenneth Broussard, MATS is an addiction (substance use disorder) counselor in Charlestown, IN. Joseph Kenneth Broussard, MATS NPI is 1326405887. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

7509 CHARLESTOWN PIKE
CHARLESTOWN, IN
ZIP 47111-623
Phone: (812) 256-4686
Fax: (812) 256-4415

The CLIA number assigned to this NPI record is 15D0671957 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 1/28/2016 and was last updated on 1/29/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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