Provider Demographics
NPI:1760367502
Name:BROUSSARD COUNSELING SERVICES
Entity type:Organization
Organization Name:BROUSSARD COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROUSSARD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, LISW
Authorized Official - Phone:563-794-5334
Mailing Address - Street 1:PO BOX 433
Mailing Address - Street 2:
Mailing Address - City:MC GREGOR
Mailing Address - State:IA
Mailing Address - Zip Code:52157-0433
Mailing Address - Country:US
Mailing Address - Phone:563-794-5334
Mailing Address - Fax:
Practice Address - Street 1:326 MAIN ST
Practice Address - Street 2:
Practice Address - City:MC GREGOR
Practice Address - State:IA
Practice Address - Zip Code:52157-8778
Practice Address - Country:US
Practice Address - Phone:563-794-5334
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty