| Behavioral Group Of Louisiana, Llc | |
|
15895 Frenchtown Rd Greenwell Springs LA 70739-3630 | |
| (901) 605-0168 | |
| Not Available |
| Full Name | Behavioral Group Of Louisiana, Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 15895 Frenchtown Rd, Greenwell Springs, Louisiana |
| Authorized Official Name and Position | Larkin Newsom (OWNER / CLINICAL DIRECTOR) |
| Authorized Official Contact | 9016050168 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Behavioral Group Of Louisiana, Llc 15895 Frenchtown Rd Greenwell Springs LA 70739-3630 Ph: (901) 605-0168 | Behavioral Group Of Louisiana, Llc 15895 Frenchtown Rd Greenwell Springs LA 70739-3630 Ph: (901) 605-0168 |
| NPI Number | 1811628241 |
|---|---|
| Provider Enumeration Date | 06/17/2022 |
| Last Update Date | 06/17/2022 |
| Certification Date | 06/17/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811628241 | NPI | - | NPPES |
| 1285135624 | Other | LA | PERSONAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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