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General NPI Number Information
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NPI Number | 1508273889
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Entity Type | Organization
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Legal Business Name | LAKE AREA COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 07/17/2014
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Last Update Date | 10/05/2015
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Provider Practice Location Address
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Address Line | 748 BAYOU PINES EAST DR SUITE B
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City | LAKE CHARLES
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State | LA
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Zip | 70601-7184
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Country | US
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Telephone | 337-532-4938
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Fax | 337-214-1836
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Provider Business Mailing Address
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Address Line | 748 BAYOU PINES EAST DR SUITE B
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City | LAKE CHARLES
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State | LA
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Zip | 70601-7184
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Country | US
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Telephone | 337-532-4938
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Fax | 337-214-1836
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Authorized Official
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Title or Position | OWNER
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Name | MS. ERIN PRIMEAUX SHOUMAKER
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Credential | M.A., LPC
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Telephone | 337-532-4938
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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 | 4512
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License Number State | LA
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