| Becerra Wellness Llc | |
|
800 Spring St Ste 202 Shreveport LA 71101-3757 | |
| (318) 200-0573 | |
| Not Available |
| Full Name | Becerra Wellness Llc |
|---|---|
| Speciality | Counselor |
| Location | 800 Spring St Ste 202, Shreveport, Louisiana |
| Authorized Official Name and Position | Michael Becerra (OWNER, DIRECTOR OF COUNSELING LPC-S) |
| Authorized Official Contact | 3182000573 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Becerra Wellness Llc 1519 Audubon Pl Shreveport LA 71105-3417 Ph: (469) 545-4611 | Becerra Wellness Llc 800 Spring St Ste 202 Shreveport LA 71101-3757 Ph: (318) 200-0573 |
| NPI Number | 1992557375 |
|---|---|
| Provider Enumeration Date | 04/01/2024 |
| Last Update Date | 04/01/2024 |
| Certification Date | 04/01/2024 |
| Medicare PECOS PAC ID | 5799124822 |
|---|---|
| Medicare Enrollment ID | O20240422002115 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992557375 | NPI | - | NPPES |
| Provider Name | Michael D Becerra |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669607438 PECOS PAC ID: 6608215736 Enrollment ID: I20240422002244 |
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