| Life Journey Wellness Of Louisiana Llc | |
|
1000 Chinaberry Dr Ste 1001 Bossier City LA 71111-2463 | |
| (318) 707-2080 | |
| (318) 532-4910 |
| Full Name | Life Journey Wellness Of Louisiana Llc |
|---|---|
| Speciality | Counselor |
| Location | 1000 Chinaberry Dr Ste 1001, Bossier City, Louisiana |
| Authorized Official Name and Position | Leslie C. Boyett (OWNER) |
| Authorized Official Contact | 3187072080 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Life Journey Wellness Of Louisiana Llc 1000 Chinaberry Dr Ste 1001 Bossier City LA 71111-2463 Ph: (318) 707-2080 | Life Journey Wellness Of Louisiana Llc 1000 Chinaberry Dr Ste 1001 Bossier City LA 71111-2463 Ph: (318) 707-2080 |
| NPI Number | 1497347090 |
|---|---|
| Provider Enumeration Date | 02/05/2021 |
| Last Update Date | 08/26/2021 |
| Certification Date | 08/26/2021 |
| Medicare PECOS PAC ID | 5496151136 |
|---|---|
| Medicare Enrollment ID | O20210907000311 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497347090 | NPI | - | NPPES |
| 1487273348 | Other | LA | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Priscilla Broussard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457679482 PECOS PAC ID: 5395141907 Enrollment ID: I20210908000080 |
Source Of Solutions Counseling Service, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2285 Benton Rd Ste D103, Bossier City, LA 71111 Phone: 318-584-7197 Fax: 318-584-7080 | |
Bossier Family Counseling, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1000 Chinaberry Dr Ste 203, Bossier City, LA 71111 Phone: 318-751-7285 | |
Unlimited Alternatives To Change, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 3018 Old Minden Rd, Ste 1117, Bossier City, LA 71112 Phone: 318-746-1935 | |
Life Restore Counseling & Training, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2223 Old Minden Rd Ste C3, Bossier City, LA 71112 Phone: 318-573-2133 | |
Women Of Diversity Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1824 Benton Rd, Bossier City, LA 71111 Phone: 318-550-5132 | |
Vision Integrated Programs Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1515 Doctors Dr, Bossier City, LA 71111 Phone: 318-742-6910 | |
Community Angels Of Hope Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2750 Shed Rd Ste D2, Bossier City, LA 71111 Phone: 318-746-4673 Fax: 318-549-9003 |