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General NPI Number Information
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NPI Number | 1588544548
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Entity Type | Individual
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Provider Name | STACEY LEBOUEF JOHNSON PPS
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Gender | Female
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Dates
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Enumeration Date | 09/02/2025
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 7106 HIGHWAY 90 W
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City | NEW IBERIA
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State | LA
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Zip | 70560-7649
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Country | US
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Telephone | 757-653-2692
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Fax |
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Provider Business Mailing Address
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Address Line | 7106 HIGHWAY 90 W
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City | NEW IBERIA
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State | LA
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Zip | 70560-7649
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Country | US
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Telephone | 757-653-2692
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 0014
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 1997934
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 000758250
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License Number State | TN
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Taxonomy #4
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 820792
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License Number State | UT
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Taxonomy #5
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 0972986
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License Number State | OK
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Taxonomy #6
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | PPS-0609322
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License Number State | VA
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