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General NPI Number Information
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NPI Number | 1801489869
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Entity Type | Organization
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Legal Business Name | MENTAL HEALTH SERVICES OF ALEXANDRIA LLC
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Dates
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Enumeration Date | 02/19/2021
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Last Update Date | 06/07/2022
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Provider Practice Location Address
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Address Line | 3600 JACKSON ST STE 117
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City | ALEXANDRIA
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State | LA
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Zip | 71303-3000
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Country | US
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Telephone | 318-704-0397
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Fax | 318-704-0396
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Provider Business Mailing Address
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Address Line | 3600 JACKSON ST STE 117
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City | ALEXANDRIA
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State | LA
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Zip | 71303-3000
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Country | US
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Telephone | 318-704-0397
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Fax | 318-704-0396
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Authorized Official
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Title or Position | SOCIAL WORKER
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Name | MS. THERESA GRACE COLE
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Credential | MSW
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Telephone | 318-787-1301
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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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