Healthcare Provider Details

I. General information

NPI: 1033423637
Provider Name (Legal Business Name): HOLISTIC COUNSELING CONCEPTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2010
Last Update Date: 08/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1205 N 18TH ST STE 215
MONROE LA
71201-5462
US

IV. Provider business mailing address

PO BOX 4436
MONROE LA
71211-4436
US

V. Phone/Fax

Practice location:
  • Phone: 318-450-5943
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: FELICIA ANTOINETTE DOWNS
Title or Position: ADMINISTRATOR
Credential:
Phone: 318-450-5943