Healthcare Provider Details

I. General information

NPI: 1104176825
Provider Name (Legal Business Name): BEYOND WORDS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2012
Last Update Date: 02/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1409 KIRKMAN ST
LAKE CHARLES LA
70601-5344
US

IV. Provider business mailing address

1409 KIRKMAN ST
LAKE CHARLES LA
70601-5344
US

V. Phone/Fax

Practice location:
  • Phone: 337-419-3586
  • Fax: 855-239-9737
Mailing address:
  • Phone: 337-419-3586
  • Fax: 855-239-9737

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TP0016X
TaxonomyPrescribing (Medical) Psychologist
License NumberMP.0018
License Number StateLA

VIII. Authorized Official

Name: DR. LAKISHA WILLIAMS
Title or Position: CLINICAL PSYCHOLOGIST
Credential: PSYD, MP
Phone: 337-419-3586