Individual provider · Type 1 NPI

Alexandrea Mae Broussard

Professional Counselor · Lake Charles, LA

NPI number 1619635612 Active

Practice location

1202 Kirkman St Ste C
Lake Charles, LA 70601-5391

Call (337) 990-5305 Map

Fax (337) 990-5306

Other practice locations

  • 710 Versailles Blvd, Alexandria, LA 71303-2351 · (318) 449-4474

Specialties and licenses

TaxonomyCodeLicense
Counselor 101Y00000XPLC9273 (LA)
Mental Health Counselor 101YM0800XPLC9273 (LA)
Case Manager/Care Coordinator 171M00000XNone listed
Professional Counselor Primary 101YP2500X9273 (LA)

Professional Counselor: Definition to come...

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About NPI 1619635612

Alexandrea Mae Broussard's National Provider Identifier is 1619635612, issued on Dec 7, 2021. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Lake Charles, LA. The record was last updated on Feb 18, 2025.