Healthcare Provider Details

I. General information

NPI: 1932292539
Provider Name (Legal Business Name): COUNSELING AND PSYCHOTHERAPY GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

714 E. KALISTE SALOOM RD.
LAFAYETTE LA
70508
US

IV. Provider business mailing address

714 E. KALISTE SALOOM RD.
LAFAYETTE LA
70508
US

V. Phone/Fax

Practice location:
  • Phone: 337-233-5127
  • Fax: 337-837-4480
Mailing address:
  • Phone: 337-233-5127
  • Fax: 337-837-4480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1048
License Number StateLA

VIII. Authorized Official

Name: MRS. BARBARA NEFF ST. ROMAIN
Title or Position: CO-OWNER
Credential: MSW, LCSW
Phone: 337-233-5127