Healthcare Provider Details

I. General information

NPI: 1801554613
Provider Name (Legal Business Name): 1ST CHOICE MENTAL HEALTH COUNSELING SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2021
Last Update Date: 11/30/2021
Certification Date: 11/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2124 HIGHWAY 754
SUNSET LA
70584-5022
US

IV. Provider business mailing address

PO BOX 1108
SUNSET LA
70584-1108
US

V. Phone/Fax

Practice location:
  • Phone: 337-418-0060
  • Fax:
Mailing address:
  • Phone: 337-418-0060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name: MRS. ALBERTA GUILBEAU
Title or Position: OWNER/OFFICE MANAGER
Credential:
Phone: 337-418-0060