Healthcare Provider Details
I. General information
NPI: 1265568034
Provider Name (Legal Business Name): LOCAL PSYCH SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/26/2007
Last Update Date: 04/27/2020
Certification Date: 04/27/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
117 MARIE ST
SUNSET LA
70584-6100
US
IV. Provider business mailing address
PO BOX 1737
SCOTT LA
70583-1737
US
V. Phone/Fax
- Phone: 337-662-0004
- Fax: 337-643-8407
- Phone: 337-288-8877
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | AP0489 |
| License Number State | LA |
VIII. Authorized Official
Name:
CYNTHIA
DUGAS
LABICHE
Title or Position: OWNER
Credential: APRN
Phone: 337-288-8877