Healthcare Provider Details

I. General information

NPI: 1669574851
Provider Name (Legal Business Name): BEHAVIORAL MEDICINE AND ADDICTIVE DISORDERS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2910 EVANGELINE ST
MONROE LA
71201-3724
US

IV. Provider business mailing address

2910 EVANGELINE ST
MONROE LA
71201-3724
US

V. Phone/Fax

Practice location:
  • Phone: 318-388-5553
  • Fax: 318-388-2190
Mailing address:
  • Phone: 318-388-5553
  • Fax: 318-388-2190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number343
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1926
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number1926
License Number StateLA
# 4
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number1926
License Number StateLA

VIII. Authorized Official

Name: DR. MITCHELL B YOUNG
Title or Position: OWNER
Credential: PHD, LPC
Phone: 318-388-5553