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General NPI Number Information
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NPI Number | 1043798184
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Entity Type | Organization
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Legal Business Name | LONGLEAF COUNSELING SERVICES LLC
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Dates
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Enumeration Date | 07/31/2018
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Last Update Date | 07/31/2018
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Provider Practice Location Address
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Address Line | 7564 BEEBE DR
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City | GREENWOOD
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State | LA
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Zip | 71033-3319
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Country | US
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Telephone | 318-658-1962
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Fax |
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Provider Business Mailing Address
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Address Line | 7564 BEEBE DR
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City | GREENWOOD
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State | LA
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Zip | 71033-3319
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Country | US
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Telephone | 318-658-1962
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DANIELLE R GOECKEL
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Credential | MS, LPC, NCC, CCTP
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Telephone | 318-658-1962
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 6199
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License Number State | LA
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