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1799 Stumpf Blvd Bldg 7 Terrytown LA 70056-3950 | |
| (504) 919-1655 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Counselor |
| Location | 1799 Stumpf Blvd Bldg 7, Terrytown, Louisiana |
| Authorized Official Name and Position | Renee Woods (OWNER/LPC) |
| Authorized Official Contact | 5044391156 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
1500 Lorene Dr Apt 174 Harvey LA 70058-3330 Ph: (504) 439-1156 | 1799 Stumpf Blvd Bldg 7 Terrytown LA 70056-3950 Ph: (504) 919-1655 |
| NPI Number | 1023659000 |
|---|---|
| Provider Enumeration Date | 10/01/2019 |
| Last Update Date | 08/28/2024 |
| Certification Date | 08/28/2024 |
| Medicare PECOS PAC ID | 8224577010 |
|---|---|
| Medicare Enrollment ID | O20240823003650 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023659000 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| Provider Name | Renee C Woods |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1366808784 PECOS PAC ID: 2668891557 Enrollment ID: I20240807003595 |
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