Healthcare Provider Details

I. General information

NPI: 1962134767
Provider Name (Legal Business Name): CWT BEHAVIORAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2022
Last Update Date: 09/18/2025
Certification Date: 09/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1324 AMBASSADOR CAFFERY PKWY
LAFAYETTE LA
70506
US

IV. Provider business mailing address

1324 AMBASSADOR CAFFERY PKWY
LAFAYETTE LA
70506-1814
US

V. Phone/Fax

Practice location:
  • Phone: 337-366-6118
  • Fax: 337-443-0456
Mailing address:
  • Phone: 337-366-6118
  • Fax: 337-443-0456

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: KYLE D JONES
Title or Position: DIRECTOR
Credential:
Phone: 337-296-0467