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KRISTEN MOREAU DUBROC
Complete NPI Record 1710562830
Counselor - Addiction (Substance Use Disorder) in Alexandria, LA

NPI Status: Active since March 10, 2021

Contact Information

3600 JACKSON ST STE 119
ALEXANDRIA, LA
ZIP 71303
Phone: (318) 625-7050

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Provider Last Name Legal Name
  4. Provider First Name
  5. Provider Middle Name
  6. Provider First Line Business Mailing Address
  7. Provider Business Mailing Address City Name
  8. Provider Business Mailing Address State Name
  9. Provider Business Mailing Address Postal Code
  10. Provider Business Mailing Address Country Code If outside U S
  11. Provider Business Mailing Address Telephone Number
  12. Provider First Line Business Practice Location Address
  13. Provider Business Practice Location Address City Name
  14. Provider Business Practice Location Address State Name
  15. Provider Business Practice Location Address Postal Code
  16. Provider Business Practice Location Address Country Code If outside U S
  17. Provider Business Practice Location Address Telephone Number
  18. Provider Enumeration Date
  19. Last Update Date
  20. Provider Gender Code
  21. Healthcare Provider Taxonomy Code 1
  22. Healthcare Provider Primary Taxonomy Switch 1
  23. Healthcare Provider Taxonomy Code 2
  24. Healthcare Provider Primary Taxonomy Switch 2
  25. Other Provider Identifier 1
  26. Other Provider Identifier Type Code 1
  27. Other Provider Identifier Issuer 1
  28. Is Sole Proprietor
  29. Healthcare Provider Taxonomy Group 2
  30. NPI Certification Date

Complete NPI Dataset

This page represents the complete record for NPI 1710562830. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1710562830
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
Entity Type Code: 1
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
The city name in the mailing address of the provider being identified.
Provider First Name: KRISTEN
The first name of the provider, if the provider is an individual.
Provider Middle Name: MOREAU
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider First Line Business Mailing Address: 2048 FUGLAAR DR
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address City Name: PINEVILLE
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider Business Mailing Address State Name: LA
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Mailing Address Postal Code: 713603416
The city name in the location address of the provider being identified.
Provider Business Mailing Address Country Code If outside U S : US
The State code in the location of the provider being identified.
Provider Business Mailing Address Telephone Number: 2544955214
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider First Line Business Practice Location Address: 3600 JACKSON ST STE 119
The country code in the location address of the provider being identified.
Provider Business Practice Location Address City Name: ALEXANDRIA
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address State Name: LA
The fax number associated with the location address of the provider being identified.
Provider Business Practice Location Address Postal Code: 713033096
The date the provider was assigned a unique identifier (assigned an NPI).
Provider Business Practice Location Address Country Code If outside U S : US
The date that a record was last updated or changed.
Provider Business Practice Location Address Telephone Number: 3186257050
The code designating the provider’s gender if the provider is a person.
Provider Enumeration Date: 3/10/2021
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Last Update Date: 11/30/2022
The date that a record was last updated or changed.
Provider Gender Code: F
The code designating the provider’s gender if the provider is a person.
Healthcare Provider Taxonomy Code 1: 171M00000X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Primary Taxonomy Switch 1: N
Healthcare Provider Taxonomy Code 2: 101YA0400X
Healthcare Provider Primary Taxonomy Switch 2: Y
Other Provider Identifier 1: 3546372
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 1: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier Issuer 1: 26352671726
Is Sole Proprietor: Y
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No
Healthcare Provider Taxonomy Group 2: 193400000X SINGLE SPECIALTY GROUP
NPI Certification Date: 11/30/2022