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NPI 1659108587

NPI 1659108587 : MAYO BEHAVIORAL HEALTH SERVICES : BATON ROUGE, LA

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General NPI Number Information
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    NPI Number           |    1659108587
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    Entity Type          |    Organization 
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    Legal Business Name  |    MAYO BEHAVIORAL HEALTH SERVICES 
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Dates
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    Enumeration Date     |    09/16/2024
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    Last Update Date     |    09/16/2024
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Provider Practice Location Address
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    Address Line         |    1120 GOVERNMENT ST 
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    City                 |    BATON ROUGE
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    State                |    LA
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    Zip                  |    70802-4802
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    Country              |    US
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    Telephone            |    225-256-0110
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 456 
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    City                 |    ZACHARY
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    State                |    LA
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    Zip                  |    70791-0456
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    Country              |    US
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    Telephone            |    225-256-0110
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     BRITTNEY BELL MAYO 
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    Credential           |    
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    Telephone            |    225-256-0110
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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        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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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        |    2084A0401X
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    Taxonomy Name        |    Addiction Medicine (Psychiatry & Neurology) Physician
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    License Number       |    
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    License Number State |    
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Taxonomy #4
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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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