Healthcare Provider Details

I. General information

NPI: 1083386023
Provider Name (Legal Business Name): THE WELL MIND, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2021
Last Update Date: 04/23/2022
Certification Date: 04/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1014 7TH ST
MORGAN CITY LA
70380-1906
US

IV. Provider business mailing address

PO BOX 1812
MORGAN CITY LA
70381-1812
US

V. Phone/Fax

Practice location:
  • Phone: 985-354-6130
  • Fax: 985-354-6086
Mailing address:
  • Phone: 985-354-6130
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. LENA MARIE TURNER
Title or Position: OWNER/MANAGER
Credential: LPC
Phone: 985-354-6130