LAKE PROFESSIONALS LLC (NPI# 1497313670) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497313670 |
| Entity Type | Organization |
| Organization Name | LAKE PROFESSIONALS LLC |
| Practice Address |
501 W Saint Mary Blvd Ste 210 Lafayette LA 70506-4699 |
| Mailing Address |
Po Box 53388 Lafayette LA 70505-3388 |
| Practice Telephone | 3372331114 |
| Mailing Telephone | 3372331114 |
| Enumeration Date | 2019-06-03 |
| Last Update Date | 2019-06-03 |
| Authorized Official Name | MR. DOUGLASS H PERRET (CEO) |
| Authorized Official Telephone | 3372331114 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| Street Address |
501 W SAINT MARY BLVD STE 210 |
| City | LAFAYETTE |
| State | LA |
| Zip Code | 70506-4699 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356900013 | Mary Elise Trahan | Counselor | 501 W Saint Mary Blvd Ste 210, Lafayette, LA 70506-4699 | 2019-06-06 |
| 1306405071 | Jennifer Rush | Counselor | 501 W Saint Mary Blvd Ste 210, Lafayette, LA 70506-4699 | 2019-06-06 |
| 1164081832 | Merril Thibodeaux | Counselor | 501 W Saint Mary Blvd Ste 210, Lafayette, LA 70506-4699 | 2019-06-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417421447 | Maranda Washington | Student in an Organized Health Care Education/Training Program | 202 Reinhardt Drive, Lafayette, LA 70506 | 2019-01-12 |
| 1447742473 | Glenda Gravouilla Poulan | Driver | 330 Guilbeau Rd, Lafayette, LA 70506 | 2018-06-05 |
| 1194215905 | Angelica Plumbar | Case Manager/Care Coordinator | 1304 Bertrand Dr Ste B21304, Lafayette, LA 70506 | 2018-05-16 |
| 1801394820 | Acadiana Ambulatory Health Care Services | Non-Pharmacy Dispensing Site | 207 Westmark Blvd., Lafayette, LA 70506 | 2018-01-24 |
| 1578070041 | Kimberly Lois Robinson | Counselor | 203 Pinto St, Lafayette, LA 70506 | 2018-01-05 |
| 1558890814 | Shanece Marie Solomon | Speech-Language Pathologist | 326 Guilbeau Rd Apt 240, Lafayette, LA 70506 | 2017-06-08 |
| 1225565625 | Keena Lewis | Case Manager/Care Coordinator | 121 Kohen Luke Dr, Lafayette, LA 70506 | 2017-05-16 |
| 1326571498 | Natasha Deville | Community/Behavioral Health | 1408 W Willow St 162, Lafayette, LA 70506 | 2017-04-06 |
| 1952846826 | Mia D Arthur | Behavioral Analyst | 511 Monarch Dr, Lafayette, LA 70506 | 2016-12-30 |
| 1265983340 | Eric Prince | Specialist/Technologist | 202 Reinhardt Dr., Lafayette, LA 70506 | 2016-10-24 |
| Find all providers in zip 70506 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821420258 | Azar & Lahood Enterprises LLC | General Practice | 111 Saint Louis St, Lafayette, LA 70506-4538 | 2013-08-08 |
| 1215369665 | Minute Med-johnston LLC | General Practice | 2912 Johnston Street, Lafayette, LA 70503 | 2013-08-07 |
| 1942539044 | Lafayette Diagnostics, Inc. | General Practice | 1019 Kaliste Saloom Rd, Suite # 711, Lafayette, LA 70508-4935 | 2009-12-18 |
| 1386972800 | Theresa Orecchia | General Practice | 285 Exempla Circle, Lafayette, CO 80026 | 2009-11-20 |
| 1760674717 | Northside High School Health Clinic | General Practice | 301 Dunand St, Lafayette, LA 70501-2215 | 2007-08-14 |
| 1225156151 | William Frederick Kortum IIi | General Practice | 3414 Moss St Ste A, Lafayette, LA 70507-6107 | 2007-03-27 |
| 1598818908 | George Edward Cobb IIi | General Practice | 3501 School Street, Lafayette, CA 94549 | 2007-01-19 |
| 1013087154 | Doctors Hearing Center LLC Lxxiv | General Practice | 4414 Johnston Street, Suite D, Lafayette, LA 70503 | 2006-11-08 |
| 1699878124 | Pernell Joseph Simon | General Practice | 207 Westmark Blvd, Lafayette, LA 70506-7365 | 2006-09-07 |
| 1366423691 | Stanley Thomas Hoover | General Practice | 1144 Coolidge, Suite D, Lafayette, LA 70503 | 2005-11-14 |
| Find all providers in LAFAYETTE | ||||
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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.