Healthcare Provider Details

I. General information

NPI: 1033993043
Provider Name (Legal Business Name): COMPREHENSIVE THERAPY CLINICS OF LOUISIANA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2023
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2033 N HIGHWAY 190 STE 10
COVINGTON LA
70433-8985
US

IV. Provider business mailing address

71683 RIVERSIDE DR
COVINGTON LA
70433-9016
US

V. Phone/Fax

Practice location:
  • Phone: 985-590-4549
  • Fax: 985-333-1217
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: BRENT M ROBERTSON
Title or Position: OWNER
Credential:
Phone: 985-590-4549