| Next Generation Therapy Services | |
|
1515 Doctors Dr Ste 4 Bossier City LA 71111 | |
| (318) 734-9165 | |
| Not Available |
| Full Name | Next Generation Therapy Services |
|---|---|
| Speciality | Social Worker |
| Location | 1515 Doctors Dr Ste 4, Bossier City, Louisiana |
| Authorized Official Name and Position | Amanda R Carroll (OWNER) |
| Authorized Official Contact | 3187349165 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Next Generation Therapy Services 1515 Doctors Dr Ste 4 Bossier City LA 71111-3321 Ph: (318) 734-9165 | Next Generation Therapy Services 1515 Doctors Dr Ste 4 Bossier City LA 71111 Ph: (318) 734-9165 |
| NPI Number | 1992297923 |
|---|---|
| Provider Enumeration Date | 06/05/2018 |
| Last Update Date | 06/05/2018 |
| Medicare PECOS PAC ID | 7618224916 |
|---|---|
| Medicare Enrollment ID | O20180718000654 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992297923 | NPI | - | NPPES |
| 1215301833 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 11022 (Louisiana) | Primary |
| Provider Name | Amanda R Carroll |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215301833 PECOS PAC ID: 4183971492 Enrollment ID: I20180718001089 |
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