Healthcare Provider Details

I. General information

NPI: 1841148087
Provider Name (Legal Business Name): CHRISTEN VILLADSEN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2026
Last Update Date: 03/20/2026
Certification Date: 03/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

648 LATIOLAIS DR
BREAUX BRIDGE LA
70517-4231
US

IV. Provider business mailing address

108 ALMA DR
BROUSSARD LA
70518-4787
US

V. Phone/Fax

Practice location:
  • Phone: 337-455-7934
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: