Healthcare Provider Details

I. General information

NPI: 1891941456
Provider Name (Legal Business Name): ASSESSMENT & PSYCHOLOGICAL SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2008
Last Update Date: 08/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10517 KENTSHIRE CT
BATON ROUGE LA
70810-2853
US

IV. Provider business mailing address

10517 KENTSHIRE CT
BATON ROUGE LA
70810-2853
US

V. Phone/Fax

Practice location:
  • Phone: 225-769-8335
  • Fax: 225-769-8396
Mailing address:
  • Phone: 225-769-8335
  • Fax: 225-769-8396

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number1984
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number751
License Number StateLA

VIII. Authorized Official

Name: MR. ROBERT PELLEGRIN
Title or Position: BUSINESS MANAGER
Credential:
Phone: 225-769-8335