Healthcare Provider Details

I. General information

NPI: 1922067131
Provider Name (Legal Business Name): SATTARIA DILKS APRN-BC, LPC,LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2006
Last Update Date: 02/17/2020
Certification Date: 02/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

324 WEST HALE ST
LAKE CHARLES LA
70601
US

IV. Provider business mailing address

324 WEST HALE ST
LAKE CHARLES LA
70601
US

V. Phone/Fax

Practice location:
  • Phone: 337-433-9177
  • Fax: 337-433-9173
Mailing address:
  • Phone: 337-433-9177
  • Fax: 337-433-9173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number442
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number140
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number039605
License Number StateLA
# 4
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number03975
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: