Healthcare Provider Details

I. General information

NPI: 1962749275
Provider Name (Legal Business Name): RESOLUTIONS COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2013
Last Update Date: 06/29/2023
Certification Date: 06/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1925 ENTERPRISE BLVD
LAKE CHARLES LA
70601-6371
US

IV. Provider business mailing address

1925 ENTERPRISE BLVD
LAKE CHARLES LA
70601-6371
US

V. Phone/Fax

Practice location:
  • Phone: 337-429-5129
  • Fax: 337-214-2077
Mailing address:
  • Phone: 337-429-5129
  • Fax: 337-214-2077

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: PEARL RICHARD NELSON
Title or Position: OWNER
Credential: PH.D
Phone: 337-429-5129