=====================================================
General NPI Number Information
=====================================================
NPI Number | 1154277853
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LEMOINE PSYCHIATRIC SERVICES LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/06/2026
-----------------------------------------------------
Last Update Date | 03/06/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 913 ALFRED ST
-----------------------------------------------------
City | SCOTT
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70583-5117
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 337-344-9910
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 913 ALFRED ST
-----------------------------------------------------
City | SCOTT
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70583-5117
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 337-344-9910
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PSYCHIATRIC NURSE PRACTITIONER
-----------------------------------------------------
Name | MICHAEL GRANT LEMOINE
-----------------------------------------------------
Credential | PMHNP-BC
-----------------------------------------------------
Telephone | 337-344-9910
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------