Provider Demographics
NPI:1245743491
Name:BILLEAUDEAUX, DARCEY (SLP)
Entity Type:Individual
Prefix:
First Name:DARCEY
Middle Name:
Last Name:BILLEAUDEAUX
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:DARCEY
Other - Middle Name:
Other - Last Name:LEWELLING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, CF- SLP
Mailing Address - Street 1:PO BOX 151
Mailing Address - Street 2:
Mailing Address - City:NEWCASTLE
Mailing Address - State:TX
Mailing Address - Zip Code:76372-0151
Mailing Address - Country:US
Mailing Address - Phone:940-550-5142
Mailing Address - Fax:
Practice Address - Street 1:1615 WOLF CIR
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70605-2348
Practice Address - Country:US
Practice Address - Phone:940-550-5142
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-09
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX400492355S0801X
LA8566235Z00000X
TX120355235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant