Healthcare Provider Details

I. General information

NPI: 1437719432
Provider Name (Legal Business Name): KARLA RENE ALEXANDER CAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2019
Last Update Date: 08/08/2023
Certification Date: 08/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

446 N 12TH ST
BATON ROUGE LA
70802-4613
US

IV. Provider business mailing address

446 N 12TH ST
BATON ROUGE LA
70802-4613
US

V. Phone/Fax

Practice location:
  • Phone: 225-636-5246
  • Fax:
Mailing address:
  • Phone: 225-636-5246
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number1621
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number15792
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: