Provider Demographics
NPI:1154446268
Name:TJBG INC
Entity Type:Organization
Organization Name:TJBG INC
Other - Org Name:JEANA C SONNIER LCSW INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:JEANA
Authorized Official - Middle Name:C
Authorized Official - Last Name:SONNIER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW LMFT
Authorized Official - Phone:337-233-2400
Mailing Address - Street 1:800 KALISTE SALOOM RD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508
Mailing Address - Country:US
Mailing Address - Phone:337-233-2400
Mailing Address - Fax:337-232-3656
Practice Address - Street 1:800 KALISTE SALOOM RD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508
Practice Address - Country:US
Practice Address - Phone:337-233-2400
Practice Address - Fax:337-232-3656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA36351041C0700X
LA939106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1456993Medicaid
LA5CK64Medicare PIN