Healthcare Provider Details

I. General information

NPI: 1326614942
Provider Name (Legal Business Name): JANINA MAYEUX PHD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2021
Last Update Date: 06/03/2021
Certification Date: 06/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2214 QUAIL RUN
BATON ROUGE LA
70808-4128
US

IV. Provider business mailing address

537 VILLARIDGE DR
BATON ROUGE LA
70810-7335
US

V. Phone/Fax

Practice location:
  • Phone: 225-425-7631
  • Fax: 225-666-0766
Mailing address:
  • Phone: 225-324-0511
  • Fax: 225-666-0766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JANINA MAYEUX
Title or Position: OWNER/CLINICAL PSYCHOLOGIST
Credential: PHD
Phone: 225-324-0511