| Mechele De Avila, Lcsw, Llc | |
|
1082 Havenwood Drive Back Apartment Baton Rouge LA 70815-6730 | |
| (225) 366-8606 | |
| (225) 410-0080 |
| Full Name | Mechele De Avila, Lcsw, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1082 Havenwood Drive, Baton Rouge, Louisiana |
| Authorized Official Name and Position | Mechele De Avila Evans (OWNER) |
| Authorized Official Contact | 5044530216 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mechele De Avila, Lcsw, Llc Po Box 41001 Baton Rouge LA 70835 Ph: (225) 366-8606 | Mechele De Avila, Lcsw, Llc 1082 Havenwood Drive Back Apartment Baton Rouge LA 70815-6730 Ph: (225) 366-8606 |
| NPI Number | 1265878318 |
|---|---|
| Provider Enumeration Date | 05/16/2013 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265878318 | NPI | - | NPPES |
| 1549495 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 4065 (Louisiana) | Primary |
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