| |
3200 Ridgelake Dr Ste 100 Metairie LA 70002-4959 | |
(504) 581-4333 | |
(504) 581-2812 |
Full Name | |
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Speciality | Counselor - Mental Health |
Location | 3200 Ridgelake Dr Ste 100, Metairie, Louisiana |
Authorized Official Name and Position | Phillip Sean Wendell (CEO) |
Authorized Official Contact | 2258104040 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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4601 Bluebonnet Blvd Ste B Baton Rouge LA 70809-9656 Ph: (225) 810-4040 | 3200 Ridgelake Dr Ste 100 Metairie LA 70002-4959 Ph: (504) 581-4333 |
NPI Number | 1306479282 |
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Provider Enumeration Date | 02/19/2020 |
Last Update Date | 04/12/2021 |
Certification Date | 04/12/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1306479282 | NPI | - | NPPES |
05700076 | Medicaid | MS | |
1455181 | Medicaid | LA | |
194084 | Other | MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
Lynn J. Friedman, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4721 Loveland St, Metairie, LA 70006 Phone: 504-455-6569 | |
Bianchini-etherton Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3939 Houma Blvd, Suite #223, Metairie, LA 70006 Phone: 504-780-1702 Fax: 504-780-1705 | |