| Beacon Behavioral Outpatient - Opelousas | |
|
5620 I 49 N Service Rd Ste 11 Opelousas LA 70570-0780 | |
| (337) 678-3611 | |
| (337) 678-3599 |
| Full Name | Beacon Behavioral Outpatient - Opelousas |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 5620 I 49 N Service Rd Ste 11, Opelousas, Louisiana |
| Authorized Official Name and Position | Phillip Sean Wendell (CEO) |
| Authorized Official Contact | 3376783611 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Beacon Behavioral Outpatient - Opelousas 4601 Bluebonnet Blvd Ste B Baton Rouge LA 70809-9656 Ph: (225) 810-4040 | Beacon Behavioral Outpatient - Opelousas 5620 I 49 N Service Rd Ste 11 Opelousas LA 70570-0780 Ph: (337) 678-3611 |
| NPI Number | 1104459064 |
|---|---|
| Provider Enumeration Date | 02/19/2020 |
| Last Update Date | 12/24/2020 |
| Certification Date | 12/24/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104459064 | NPI | - | NPPES |
| 194112 | Other | MEDICARE | |
| 2700227 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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