Individual
ALEXIS BROUSSARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
3312 KALISTE SALOOM RD, LAFAYETTE, LA 70508-7449
(337) 237-0788
Mailing address
318 ELYSIAN FIELDS DR, LAFAYETTE, LA 70508-6056
(337) 654-7031
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
17163
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1701033
—
LA
Enumeration date
08/18/2022
Last updated
08/20/2025
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