MEDICARE: AL-JOEL COUNSELING SERVICES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1033863030
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AL-JOEL COUNSELING SERVICES, LLC

Provider Business Mailing Address
First Line	:	209 OREGON TRL
Second Line	:
City	:	MONROE
State	:	LA
Zip	:	71202-3721
Country	:	US
Telephone Number	:	318-538-8033
Fax Number	:

Provider Business Practice Location Address
First Line	:	201 CENTURY VILLAGE BLVD STE 248
Second Line	:
City	:	MONROE
State	:	LA
Zip	:	71203-2008
Country	:	US
Telephone Number	:	318-750-2377
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	MONEEKA LATRICE HENDERSON
Credential	:	N/A
Telephone Number	:	318-538-8033

Provider Enumeration Date	:	02/08/2022
Last Update Date	:	02/08/2022

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