| Peaceful Alternatives Counseling And Therapy, Llc | |
|
5902 Buncombe Rd Shreveport LA 71129-4004 | |
| (318) 670-8898 | |
| (318) 300-3772 |
| Full Name | Peaceful Alternatives Counseling And Therapy, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 5902 Buncombe Rd, Shreveport, Louisiana |
| Authorized Official Name and Position | Robert Terry (DIRECTOR OF BUSINESS OPERATION/ MHP) |
| Authorized Official Contact | 3186708898 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Peaceful Alternatives Counseling And Therapy, Llc Po Box 29372 Shreveport LA 71149 Ph: (318) 670-8898 | Peaceful Alternatives Counseling And Therapy, Llc 5902 Buncombe Rd Shreveport LA 71129-4004 Ph: (318) 670-8898 |
| NPI Number | 1447512512 |
|---|---|
| Provider Enumeration Date | 06/13/2012 |
| Last Update Date | 06/23/2023 |
| Certification Date | 06/23/2023 |
| Medicare PECOS PAC ID | 8022380377 |
|---|---|
| Medicare Enrollment ID | O20170821002733 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447512512 | NPI | - | NPPES |
| BH0012168 | Other | LA | LOUISIANA DEPARTMENT OF HEALTH: BEHAVIORAL HEALTH |
| BH0011860 | Other | LA | LOUISIANA DEPARTMENT OF HEALTH: BEHAVIORAL HEALTH LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Swamy Suresh Sabbenahalli Narayana |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528372505 PECOS PAC ID: 1759608581 Enrollment ID: I20150316001439 |
| Provider Name | Katherine Delorse Washington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093191678 PECOS PAC ID: 0042529539 Enrollment ID: I20151023000899 |
| Provider Name | Antwan Butler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528461480 PECOS PAC ID: 7618241092 Enrollment ID: I20170923000304 |
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