Healthcare Provider Details

I. General information

NPI: 1033035332
Provider Name (Legal Business Name): MIND OVER MATTER BEHAVIORAL HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

143 FITZWILLIAM ST
HAUGHTON LA
71037-8777
US

IV. Provider business mailing address

143 FITZWILLIAM ST
HAUGHTON LA
71037-8777
US

V. Phone/Fax

Practice location:
  • Phone: 318-423-3993
  • Fax:
Mailing address:
  • Phone: 318-423-3993
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: KATRENIA WHITE
Title or Position: OWNER
Credential:
Phone: 318-423-3993