Healthcare Provider Details

I. General information

NPI: 1588910947
Provider Name (Legal Business Name): POST TRAUMA INSTITUTE OF LOUISIANA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2012
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11911 JUSTICE AVE
BATON ROUGE LA
70816-2373
US

IV. Provider business mailing address

PO BOX 83814
BATON ROUGE LA
70884-3814
US

V. Phone/Fax

Practice location:
  • Phone: 225-751-5412
  • Fax: 225-751-5847
Mailing address:
  • Phone: 225-751-5412
  • Fax: 225-751-5847

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number4245
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number0304
License Number StateLA
# 4
Primary TaxonomyN
Taxonomy Code103TP0016X
TaxonomyPrescribing (Medical) Psychologist
License NumberMPAP 000015
License Number StateLA
# 5
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number10554
License Number StateLA
# 6
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 8
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number19D2061587
License Number StateLA

VIII. Authorized Official

Name: DR. LAWRENCE SULLIVAN SALONE SR.
Title or Position: FOUNDER
Credential: PHD
Phone: 225-751-5412