| Mental Health Services Of Alexandria Llc | |
|
3600 Jackson St Ste 117 Alexandria LA 71303-3000 | |
| (318) 704-0397 | |
| (318) 704-0396 |
| Full Name | Mental Health Services Of Alexandria Llc |
|---|---|
| Speciality | Social Worker |
| Location | 3600 Jackson St Ste 117, Alexandria, Louisiana |
| Authorized Official Name and Position | Theresa Grace Cole (SOCIAL WORKER) |
| Authorized Official Contact | 3187871301 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mental Health Services Of Alexandria Llc 3600 Jackson St Ste 117 Alexandria LA 71303-3000 Ph: (318) 704-0397 | Mental Health Services Of Alexandria Llc 3600 Jackson St Ste 117 Alexandria LA 71303-3000 Ph: (318) 704-0397 |
| NPI Number | 1801489869 |
|---|---|
| Provider Enumeration Date | 02/19/2021 |
| Last Update Date | 06/07/2022 |
| Certification Date | 05/14/2022 |
| Medicare PECOS PAC ID | 4587046842 |
|---|---|
| Medicare Enrollment ID | O20220803000214 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801489869 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Theresa Grace Cole |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568515435 PECOS PAC ID: 6709036064 Enrollment ID: I20121022000604 |
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