Healthcare Provider Details

I. General information

NPI: 1336576917
Provider Name (Legal Business Name): HEALTHPOINT PROFESSIONAL SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2013
Last Update Date: 09/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1818 AVENUE OF AMERICA
MONROE LA
71201-4530
US

IV. Provider business mailing address

1818 AVENUE OF AMERICA
MONROE LA
71201-4530
US

V. Phone/Fax

Practice location:
  • Phone: 318-998-2700
  • Fax:
Mailing address:
  • Phone: 318-998-2700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number1192
License Number StateLA

VIII. Authorized Official

Name: DR. TERRY OLIVER THOMAS
Title or Position: PRESIDENT
Credential: PHD
Phone: 318-348-6171