Healthcare Provider Details

I. General information

NPI: 1831963099
Provider Name (Legal Business Name): CHOSEN NURSING CONSULTANT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2023
Last Update Date: 06/05/2024
Certification Date: 06/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2285 NORTH ST
BATON ROUGE LA
70802-3154
US

IV. Provider business mailing address

2285 NORTH ST
BATON ROUGE LA
70802-3154
US

V. Phone/Fax

Practice location:
  • Phone: 225-218-5647
  • Fax: 225-529-3821
Mailing address:
  • Phone: 225-218-5647
  • Fax: 225-529-3821

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TIFFANY UPSHAW
Title or Position: ADMINISTRATOR
Credential:
Phone: 816-349-2175