=====================================================
General NPI Number Information
=====================================================
NPI Number | 1023929833
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BACS L.L.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/14/2026
-----------------------------------------------------
Last Update Date | 09/14/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 143 RIDGEWAY DR STE 218
-----------------------------------------------------
City | LAFAYETTE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70503-3494
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 337-306-3366
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 143 RIDGEWAY DR STE 218
-----------------------------------------------------
City | LAFAYETTE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70503-3494
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 337-306-3366
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MENTAL HEALTH COUNSELOR
-----------------------------------------------------
Name | ELIZABETH A EWING
-----------------------------------------------------
Credential | LPC
-----------------------------------------------------
Telephone | 318-245-5808
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------