| Grief Recovery Center | |
|
4919 Jamestown Ave Suite 102 Baton Rouge LA 70808-3228 | |
| (225) 924-6621 | |
| (225) 924-6627 |
| Full Name | Grief Recovery Center |
|---|---|
| Speciality | Social Worker |
| Location | 4919 Jamestown Ave, Baton Rouge, Louisiana |
| Authorized Official Name and Position | Kathy R Vilas (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2259246621 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Grief Recovery Center 4919 Jamestown Ave Suite 102 Baton Rouge LA 70808-3228 Ph: (225) 924-6621 | Grief Recovery Center 4919 Jamestown Ave Suite 102 Baton Rouge LA 70808-3228 Ph: (225) 924-6621 |
| NPI Number | 1407079163 |
|---|---|
| Provider Enumeration Date | 04/11/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 4082710132 |
|---|---|
| Medicare Enrollment ID | O20070507000044 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407079163 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 1041C0700X (Louisiana) | Primary |
| Provider Name | Mary Ann Abel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255664157 PECOS PAC ID: 1153504154 Enrollment ID: I20110329000797 |
| Provider Name | Gretchen G Bankston |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578616348 PECOS PAC ID: 3678757622 Enrollment ID: I20110415000303 |
| Provider Name | Esther M Sachse |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437626207 PECOS PAC ID: 9436181633 Enrollment ID: I20200312002027 |
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