Healthcare Provider Details

I. General information

NPI: 1497667950
Provider Name (Legal Business Name): ACADIAN HEALTH ALLIANCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 AUDUBON BLVD
LAFAYETTE LA
70503-2606
US

IV. Provider business mailing address

117 AUDUBON BLVD
LAFAYETTE LA
70503-2606
US

V. Phone/Fax

Practice location:
  • Phone: 901-631-1241
  • Fax:
Mailing address:
  • Phone: 901-631-1241
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
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: PAUL AZAR
Title or Position: DIRECTOR
Credential:
Phone: 901-631-1241