MEDICARE: KASSIE PRESNELL

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	101YM0800X	Mental Health Counselor	9905	LA
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	LAC-5152	LA

General Provider Information

NPI Number	:	1457019507
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KASSIE PRESNELL

Provider Business Mailing Address
First Line	:	12305 HIGHLAND DR
Second Line	:
City	:	GEISMAR
State	:	LA
Zip	:	70734-3152
Country	:	US
Telephone Number	:	225-888-4844
Fax Number	:

Provider Business Practice Location Address
First Line	:	3835 CHOCTAW DR
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70805
Country	:	US
Telephone Number	:	225-888-4844
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/06/2021
Last Update Date	:	06/29/2026

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Directions to “ KASSIE PRESNELL ” Practice Location

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