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General NPI Number Information
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NPI Number | 1578263703
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Entity Type | Organization
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Legal Business Name | TRAUMA RECOVERY & COUNSELING SERVICES
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Dates
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Enumeration Date | 03/07/2023
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 8369 FLORIDA BLVD STE 3
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City | DENHAM SPRINGS
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State | LA
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Zip | 70726-7862
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Country | US
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Telephone | 225-242-9865
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Fax |
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Provider Business Mailing Address
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Address Line | 18522 BELLINGRATH LAKES AVE
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City | GREENWELL SPRINGS
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State | LA
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Zip | 70739-4766
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Country | US
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Telephone | 225-242-9865
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Fax |
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | KIMBERLEE RILES-STEWART
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Credential | LPC
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Telephone | 225-242-9865
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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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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