Healthcare Provider Details

I. General information

NPI: 1821333584
Provider Name (Legal Business Name): NORTH TANGI COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2012
Last Update Date: 02/13/2023
Certification Date: 02/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1011 NW CENTRAL AVE STE D
AMITE LA
70422-5723
US

IV. Provider business mailing address

PO BOX 762
AMITE LA
70422-0762
US

V. Phone/Fax

Practice location:
  • Phone: 985-474-5455
  • Fax: 888-671-0753
Mailing address:
  • Phone: 985-474-5455
  • Fax: 888-671-0753

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberBH0012217
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LATONYA SMITH
Title or Position: OWNER
Credential: LPC
Phone: 985-514-6622