Healthcare Provider Details

I. General information

NPI: 1902463920
Provider Name (Legal Business Name): BRIANA BERNITA CLAY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2019
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3112 W PINHOOK RD STE B
LAFAYETTE LA
70508-3443
US

IV. Provider business mailing address

1405 W PINHOOK RD STE 111
LAFAYETTE LA
70503-3100
US

V. Phone/Fax

Practice location:
  • Phone: 337-703-2806
  • Fax: 337-205-4559
Mailing address:
  • Phone: 336-703-2806
  • Fax: 337-205-4559

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: