MARK SHANNON BROUSSARD LAC, CCS
NPI 1255833661
Counselor - Addiction (Substance Use Disorder) in Baton Rouge, LA

Q: What is Mark Broussard's NPI number?

The NPI number for Mark Broussard is 1255833661. It was assigned to this individual provider in the NPPES registry on March 1, 2018.

Q: What is Mark Broussard's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

Q: When was this NPI record last updated?

The NPPES record for Mark Broussard was last updated on March 1, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 01, 2018

5431 SUPERIOR DR, BATON ROUGE, LA 70816(225) 964-5000 Get Directions Write a Review

NPPES record last updated: March 1, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Mark Shannon Broussard Lac, Ccs NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARK SHANNON BROUSSARD LAC, CCS (NPI 1255833661) is an individual addiction (substance use disorder) provider in Baton Rouge, Louisiana, licensed in Louisiana (661) and active in the NPI registry since March 2018.

NPPES Registry Identity

NPI1255833661

Entity TypeIndividualMale

Primary Taxonomy101YA0400X

Provider Legal NameMARK SHANNON BROUSSARDCredential: LAC, CCS

Location Address5431 SUPERIOR DRBaton Rouge, LA 70816-6044

Mailing Address6421 Perkins Rd Ste ABaton Rouge, LA 70808-6200 · (225) 924-3000 · Fax (225) 924-3030

Phone(225) 964-5000

Sole ProprietorYes

Enumeration DateMarch 1, 2018

✔ NPI 1255833661 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers

Taxonomy Code101YA0400X

License✔ Licensed in LA · 661

5431 SUPERIOR DR, Baton Rouge, LA 70816

Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PATRICE M WALKER RN

Registered Nurse

5431 SUPERIOR DR
BATON ROUGE, LA 70816

East Baton Rouge Parish (225) 324-6083

MS. DANIELLE MICHELLE DOMINGUE CIT

Case Manager/Care Coordinator

5431 SUPERIOR DR
BATON ROUGE, LA 70816

East Baton Rouge Parish (225) 929-6355

ASHLEY KING ARMSTRONG

Case Manager/Care Coordinator

5431 SUPERIOR DR
BATON ROUGE, LA 70816

East Baton Rouge Parish (225) 964-5000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mark Broussard's NPI number?

The NPI number for Mark Broussard is 1255833661. It was assigned to this individual provider in the NPPES registry on March 1, 2018.

Where is Mark Broussard located?

Mark Broussard practices at 5431 Superior Dr, Baton Rouge, LA 70816. The listed phone number is (225) 964-5000.

What is Mark Broussard's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Mark Broussard was last updated on March 1, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.