Healthcare Provider Details

I. General information

NPI: 1649199969
Provider Name (Legal Business Name): PARADIGM SHIFT BEHAVIORAL HEALTH & WELLNESS CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2026
Last Update Date: 07/11/2026
Certification Date: 07/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2807 5TH AVE
LAKE CHARLES LA
70601-7913
US

IV. Provider business mailing address

2807 5TH AVE
LAKE CHARLES LA
70601-7913
US

V. Phone/Fax

Practice location:
  • Phone: 337-309-6868
  • Fax:
Mailing address:
  • Phone: 337-309-6868
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: BARBARA BERARD
Title or Position: MEMBER
Credential:
Phone: 504-419-7707