Healthcare Provider Details

I. General information

NPI: 1457019507
Provider Name (Legal Business Name): KASSIE PRESNELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2021
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3835 CHOCTAW DR
BATON ROUGE LA
70805
US

IV. Provider business mailing address

12305 HIGHLAND DR
GEISMAR LA
70734-3152
US

V. Phone/Fax

Practice location:
  • Phone: 225-888-4844
  • Fax:
Mailing address:
  • Phone: 225-888-4844
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLAC-5152
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number9905
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: