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General NPI Number Information
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NPI Number | 1699076364
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Entity Type | Organization
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Legal Business Name | METAMORPHOSIS COUNSELING CENTER, LLC.
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Dates
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Enumeration Date | 11/10/2010
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Last Update Date | 07/11/2016
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Provider Practice Location Address
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Address Line | 1457 4H CLUB RD SUITE C
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City | DENHAM SPRINGS
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State | LA
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Zip | 70726-4972
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Country | US
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Telephone | 225-993-8301
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Fax | 225-243-7652
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Provider Business Mailing Address
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Address Line | PO BOX 1387
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City | DENHAM SPRINGS
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State | LA
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Zip | 70727-1387
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Country | US
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Telephone | 225-993-8301
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Fax | 225-243-7652
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Authorized Official
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Title or Position | OWNER
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Name | MS. TARA MICHELLE DEMARS
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Credential | LCSW
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Telephone | 225-993-8301
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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