Healthcare Provider Details

I. General information

NPI: 1851933576
Provider Name (Legal Business Name): POSSIBILITIES COUNSELING SERVICES FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2019
Last Update Date: 10/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1003 S HUNTINGTON ST
SULPHUR LA
70663-4837
US

IV. Provider business mailing address

1003 S HUNTINGTON ST
SULPHUR LA
70663-4837
US

V. Phone/Fax

Practice location:
  • Phone: 337-313-3108
  • Fax: 337-313-3347
Mailing address:
  • Phone: 337-313-3108
  • Fax: 337-313-3347

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MILDRED MICHELLE RODRIGUEZ
Title or Position: CEO
Credential: LPCS, LMFT
Phone: 337-313-3108