MS. DESIRAE CHIASSON (NPI# 1649642737) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649642737 |
| Entity Type | Individual |
| Full Name | MS. DESIRAE CHIASSON |
| Credential | MA |
| Practice Address |
412 Supercharge Dr Thibodaux LA 70301 |
| Mailing Address |
412 Supercharge Dr Thibodaux LA 70301-6141 |
| Practice Telephone | 9858599777 |
| Mailing Telephone | 9858599777 |
| Enumeration Date | 2015-10-28 |
| Last Update Date | 2019-09-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
| Y | 101YP2500X |
Counselor Specialization: Professional |
6686 | LA | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 406 W 3rd St, Thibodaux, LA 70301 | 9858599777 | |
| 939 Choctow Rd, Thibodaux, LA 703017244 | 9858599777 |
| Street Address |
412 SUPERCHARGE DR |
| City | THIBODAUX |
| State | LA |
| Zip Code | 70301 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225539620 | Micah Aaron Callais | Nurse Practitioner | 604 N. Acadia Road, Suite 200, Thibodaux, LA 70301 | 2018-02-22 |
| 1982112348 | Katie Leblanc | Massage Therapist | 1115 St. Mary Street, Thibodaux, LA 70301 | 2018-01-18 |
| 1154837391 | Texas Digestive Disease Consultants, Pllc | Internal Medicine | 764 North Acadia Road, Suite A, Thibodaux, LA 70301 | 2017-12-26 |
| 1235648239 | Speech and Feeding Therapy, LLC | Speech-Language Pathologist | 1000 Plantation Rd Ste 1a, Thibodaux, LA 70301 | 2017-09-22 |
| 1285150466 | Tara Payne | Counselor | 303 Hickory Street, Thibodaux, LA 70301 | 2017-08-18 |
| 1427583475 | Tyler Pettigrew | Counselor | 300 Plantation Rd., Apt #24, Thibodaux, LA 70301 | 2017-04-27 |
| 1750825758 | Jessica Barquet | Counselor | 110 Palm Villa Dr Apt 1, Thibodaux, LA 70301 | 2016-12-09 |
| 1013468230 | Shenee Haas Gros | Counselor | 504 Cherry St., Thibodaux, LA 70301 | 2016-10-24 |
| 1982155388 | Southern Ent Associates Inc | Audiologist | 604 North Acadia Road Suite 101, Thibodaux, LA 70301 | 2016-10-20 |
| 1215483888 | Lesheeca Norman, Lpc | Counselor | 306 Victoria Court, Thibodaux, LA 70301 | 2016-09-01 |
| Find all providers in zip 70301 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922648674 | Jerome Wilson | Counselor | 100 Diplomat Way, Thibodaux, LA 70301-4314 | 2020-01-10 |
| 1114414588 | Tanya M. Breaux | Counselor | 806 N Acadia Rd, Thibodaux, LA 70301-5012 | 2018-04-20 |
| 1285150466 | Tara Payne | Counselor | 303 Hickory Street, Thibodaux, LA 70301 | 2017-08-18 |
| 1407380934 | Michael Disalvo | Counselor | 142 Rue Marguerite Apt A, Thibodaux, LA 70301-6746 | 2017-04-11 |
| 1356873533 | Tracy L Reed | Counselor | 111 Leonard St, Thibodaux, LA 70301-4117 | 2017-03-28 |
| 1538526181 | Bonnie Fortson | Counselor | 300 Plantation Rd Apt 1, Thibodaux, LA 70301-4442 | 2016-01-26 |
| 1659787190 | Richard Naquin | Counselor | 519 Blake Ct, Thibodaux, LA 70301-3503 | 2014-07-04 |
| 1730594920 | Lester Olinde | Counselor | 205 Dorothy St, Thibodaux, LA 70301-5517 | 2014-06-25 |
| 1851636898 | Brittney Henry | Counselor | 142 Laura Dr, Suite D, Thibodaux, LA 70301-2988 | 2012-12-03 |
| 1023387925 | Chantrelle Deron Varnado-johnson | Counselor | 906 East 1st Stret, Thibodaux, LA 70310-5848 | 2011-12-21 |
| Find all providers in THIBODAUX | ||||
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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.