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NPI Code Detail

MEDICARE: RESURRECTION & NEW LIFE FELLOWSHIP

MEDICARE: RESURRECTION & NEW LIFE FELLOWSHIP
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
1101YP1600XPastoral Counselor
2101YP2500XProfessional Counselor
3101YM0800XMental Health Counselor
4374K00000XReligious Nonmedical Practitioner
5171M00000XCase Manager/Care Coordinator

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1932504842
Entity Type Code : Organization
Provider Name (Legal Business Name) : RESURRECTION & NEW LIFE FELLOWSHIP
Provider Business Mailing Address
First Line : PO BOX 45698
Second Line :
City : BATON ROUGE
State : LA
Zip : 70895-4698
Country : US
Telephone Number : 225-924-9164
Fax Number : 225-924-5479
Provider Business Practice Location Address
First Line : 7569 E INDUSTRIAL DR
Second Line :
City : BATON ROUGE
State : LA
Zip : 70805-7518
Country : US
Telephone Number : 225-924-9164
Fax Number : 225-924-5479
Authorized Official
Title or Position : CLINICAL COORDINATOR/SR. PASTOR
Name : DR. LEONARD DARNELL TENNART
Credential : PHD, DMIN, LPC, BCC,
Telephone Number : 225-924-9164
Provider Enumeration Date : 11/04/2014
Last Update Date : 05/01/2018

Similar Medicare Providers

1083031488 — DR. LEONARD TENNART LPC
Practice Location Address:
7569 E INDUSTRIAL DR
BATON ROUGE, LA
70805-7518
Practice Phone: 225-302-7769
Practice Fax: 225-389-6331
1730693987 — MRS. GLORIA ELAINE TENNART BCPC
Practice Location Address:
7569 E INDUSTRIAL DR
BATON ROUGE, LA
70805-7518
Practice Phone: 225-924-9164
Practice Fax: 225-924-5479
1205340114 — MAZIEN BUTLER BCPC
Practice Location Address:
7569 E INDUSTRIAL DR
BATON ROUGE, LA
70805-7518
Practice Phone: 225-924-9164
Practice Fax: 225-924-5479
1376031740 — KIESHIA M DOHERTY
Practice Location Address:
7569 E INDUSTRIAL DR
BATON ROUGE, LA
70805-7518
Practice Phone: 225-924-9164
Practice Fax: 225-924-5479
1225527658 — RNLF COUNSELING SERVICES
Practice Location Address:
7569 E INDUSTRIAL DR
BATON ROUGE, LA
70805-7518
Practice Phone: 225-924-9164
Practice Fax: 225-924-5479
1588153159 — LASHUNDA BRAXTON
Practice Location Address:
7569 E INDUSTRIAL DR
BATON ROUGE, LA
70805-7518
Practice Phone: 225-924-9164
Practice Fax: 225-924-5479

Directions to “RESURRECTION & NEW LIFE FELLOWSHIP ” Practice Location

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