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General NPI Number Information
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NPI Number | 1245516897
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Entity Type | Organization
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Legal Business Name | YOUTH SERVICE BUREAU OF ST TAMMANY
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Dates
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Enumeration Date | 10/27/2011
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Last Update Date | 08/06/2024
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Provider Practice Location Address
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Address Line | 430 N NEW HAMPSHIRE ST
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City | COVINGTON
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State | LA
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Zip | 70433-2830
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Country | US
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Telephone | 985-893-2570
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Fax | 985-893-2758
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Provider Business Mailing Address
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Address Line | 430 N NEW HAMPSHIRE ST
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City | COVINGTON
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State | LA
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Zip | 70433-2830
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Country | US
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Telephone | 985-893-2570
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Fax | 985-893-2758
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Authorized Official
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Title or Position | PRESIDENT & CEO
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Name | MR. CLEVELAND WESTER
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Credential | LCSW
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Telephone | 985-893-2570
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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 | 194A
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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