| |
33847 Nicole Ln Denham Springs LA 70706-2048 | |
(225) 936-9383 | |
(225) 664-8772 |
Full Name | |
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Speciality | Counselor |
Location | 33847 Nicole Ln, Denham Springs, Louisiana |
Authorized Official Name and Position | Annette Sias Toussaint (OWNER) |
Authorized Official Contact | 2259369383 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 40466 Baton Rouge LA 70835-0466 Ph: (225) 936-9383 | 33847 Nicole Ln Denham Springs LA 70706-2048 Ph: (225) 936-9383 |
NPI Number | 1043834104 |
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Provider Enumeration Date | 06/04/2020 |
Last Update Date | 10/18/2021 |
Certification Date | 10/18/2021 |
Medicare PECOS PAC ID | 6507202827 |
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Medicare Enrollment ID | O20240308003312 |
Identifier | Type | State | Issuer |
---|---|---|---|
1043834104 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
Provider Name | Annette Sias Toussaint |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1477067676 PECOS PAC ID: 5799136941 Enrollment ID: I20240308003457 |
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