Healthcare Provider Details

I. General information

NPI: 1588973176
Provider Name (Legal Business Name): LINCOLN COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2010
Last Update Date: 12/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

617 S TRENTON ST
RUSTON LA
71270-5040
US

IV. Provider business mailing address

617 S TRENTON ST
RUSTON LA
71270-5040
US

V. Phone/Fax

Practice location:
  • Phone: 318-251-4659
  • Fax: 318-251-4659
Mailing address:
  • Phone: 318-251-4659
  • Fax: 318-251-4659

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number1137
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number1137
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1004
License Number StateLA
# 4
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1519
License Number StateLA
# 5
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number1004
License Number StateLA

VIII. Authorized Official

Name: CHRIS H SALTER
Title or Position: OWNER
Credential: SAP, CCS, LAC, CCGC
Phone: 318-251-4659