MEDICARE: BEE STILL GRIEF & LOSS COUNSELING, 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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1831779214
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEE STILL GRIEF & LOSS COUNSELING, LLC

Provider Business Mailing Address
First Line	:	1600 N SUGAR RIDGE RD
Second Line	:
City	:	LA PLACE
State	:	LA
Zip	:	70068-6126
Country	:	US
Telephone Number	:	504-417-6022
Fax Number	:

Provider Business Practice Location Address
First Line	:	7 GREENWOOD DR
Second Line	:
City	:	DESTREHAN
State	:	LA
Zip	:	70047-2129
Country	:	US
Telephone Number	:	504-233-8851
Fax Number	:

Authorized Official
Title or Position	:	PSYCHOTHERAPIST/OWNER
Name	:	MISS BRANDIE J HICKS
Credential	:	MS, LPC
Telephone Number	:	504-233-8851

Provider Enumeration Date	:	04/10/2021
Last Update Date	:	04/10/2021

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