1952817157 NPI number — MARY BETH BLANCHET M.A., BCBA, LBA

Table of content: MARY BETH BLANCHET M.A., BCBA, LBA (NPI 1952817157)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952817157 NPI number — MARY BETH BLANCHET M.A., BCBA, LBA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BLANCHET
Provider First Name:
MARY
Provider Middle Name:
BETH
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.A., BCBA, LBA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1952817157
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/22/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6351 HIGHWAY 11 N
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PICAYUNE
Provider Business Mailing Address State Name:
MS
Provider Business Mailing Address Postal Code:
39466-7872
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
318-491-3270
Provider Business Mailing Address Fax Number:
985-317-0135

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1214 S MAIN ST STE B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
POPLARVILLE
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
39470-3309
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
985-951-3355
Provider Business Practice Location Address Fax Number:
985-317-0135
Provider Enumeration Date:
12/26/2017

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103K00000X , registered in the state of MS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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