| Dickens Inspired Llc | |
|
114 Representative Row Suite B Lafayette LA 70508-3878 | |
| (337) 412-6555 | |
| Not Available |
| Full Name | Dickens Inspired Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 114 Representative Row, Lafayette, Louisiana |
| Authorized Official Name and Position | Nicole Dickens (PRESIDENT) |
| Authorized Official Contact | 3374126555 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dickens Inspired Llc 114 Representative Row Suite B Lafayette LA 70508-3878 Ph: (337) 412-6555 | Dickens Inspired Llc 114 Representative Row Suite B Lafayette LA 70508-3878 Ph: (337) 412-6555 |
| NPI Number | 1922499698 |
|---|---|
| Provider Enumeration Date | 02/16/2015 |
| Last Update Date | 01/12/2016 |
| Medicare PECOS PAC ID | 9830410471 |
|---|---|
| Medicare Enrollment ID | O20150608001136 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922499698 | NPI | - | NPPES |
| 1564079 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 13406R (Louisiana) | Primary |
| Provider Name | Nicole Dickens |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376522516 PECOS PAC ID: 9032203344 Enrollment ID: I20070926000287 |
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