Healthcare Provider Details

I. General information

NPI: 1063952802
Provider Name (Legal Business Name): LSC LPC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2017
Last Update Date: 02/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

717 S FOSTER DR STE 140
BATON ROUGE LA
70806-5943
US

IV. Provider business mailing address

717 S FOSTER DR STE 140
BATON ROUGE LA
70806-5943
US

V. Phone/Fax

Practice location:
  • Phone: 225-443-2012
  • Fax:
Mailing address:
  • Phone: 225-443-2012
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number5507
License Number StateLA

VIII. Authorized Official

Name: LISA CURLEY
Title or Position: MANAGER
Credential: LPC
Phone: 225-443-2012