Healthcare Provider Details

I. General information

NPI: 1982136859
Provider Name (Legal Business Name): LERON BAPTISTE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2017
Last Update Date: 03/30/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

733 KEYSER AVE
NATCHITOCHES LA
71457-0030
US

IV. Provider business mailing address

733 KEYSER AVE
NATCHITOCHES LA
71457-0030
US

V. Phone/Fax

Practice location:
  • Phone: 318-238-4030
  • Fax: 318-787-5768
Mailing address:
  • Phone: 318-238-4030
  • Fax: 318-787-5768

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: