Northeast Counseling, Llc | |
343 N Washington St Bastrop LA 71220-3849 | |
(318) 974-5075 | |
(844) 270-1958 |
Full Name | Northeast Counseling, Llc |
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Speciality | Clinic/Center |
Location | 343 N Washington St, Bastrop, Louisiana |
Authorized Official Name and Position | Terrance Key (BUSINESS OWNER) |
Authorized Official Contact | 3186807792 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Northeast Counseling, Llc 343 N Washington St Bastrop LA 71220-3849 Ph: (318) 974-5075 | Northeast Counseling, Llc 343 N Washington St Bastrop LA 71220-3849 Ph: (318) 974-5075 |
NPI Number | 1497113559 |
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Provider Enumeration Date | 02/04/2016 |
Last Update Date | 06/21/2023 |
Certification Date | 06/21/2023 |
Medicare PECOS PAC ID | 7911395579 |
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Medicare Enrollment ID | O20211101001451 |
Identifier | Type | State | Issuer |
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1497113559 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Provider Name | Kaissy Hammer |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1275813834 PECOS PAC ID: 0446415418 Enrollment ID: I20120626000585 |
Therapeutic Interventions Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 9080 Westwood Dr., Null, Bastrop, LA 71220 Phone: 318-237-8000 | |