Healthcare Provider Details

I. General information

NPI: 1033646328
Provider Name (Legal Business Name): CONNECTION TO CARE COUNSELING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2017
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1758 TEXAS ST
NATCHITOCHES LA
71457-3429
US

IV. Provider business mailing address

PO BOX 7442
NATCHITOCHES LA
71457-0442
US

V. Phone/Fax

Practice location:
  • Phone: 318-527-9452
  • Fax:
Mailing address:
  • Phone: 318-527-9452
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: SHARON BEARD
Title or Position: PROFESSIONAL COUNSELOR
Credential: LPC
Phone: 318-527-9452