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General NPI Number Information
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NPI Number | 1184392813
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Entity Type | Organization
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Legal Business Name | COUNSELING CENTER OF WEST LOUISIANA
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Dates
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Enumeration Date | 08/30/2021
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Last Update Date | 09/27/2021
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Provider Practice Location Address
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Address Line | 100 E TEXAS ST
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City | LEESVILLE
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State | LA
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Zip | 71446-4054
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Country | US
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Telephone | 318-623-2072
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Fax |
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Provider Business Mailing Address
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Address Line | 1105 NOLAN TRCE
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City | LEESVILLE
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State | LA
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Zip | 71446-3837
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Country | US
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Telephone | 318-623-2072
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | MRS. KIMBERLY AARON SIMMS
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Credential | LPC, LMFT, MAC
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Telephone | 318-623-2072
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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