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General NPI Number Information
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NPI Number | 1912705096
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Entity Type | Organization
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Legal Business Name | PATRICK L. LANDAICHE, LCSW, LLC
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Dates
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Enumeration Date | 03/05/2025
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Last Update Date | 03/05/2025
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Provider Practice Location Address
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Address Line | 2333 GOVERNMENT ST
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City | BATON ROUGE
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State | LA
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Zip | 70806-5316
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Country | US
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Telephone | 225-406-7322
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Fax |
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Provider Business Mailing Address
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Address Line | 17367 WRENWOOD DR
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City | PRAIRIEVILLE
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State | LA
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Zip | 70769-4052
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Country | US
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Telephone | 225-406-7322
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. PATRICK LANDAICHE
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Credential | LCSW
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Telephone | 225-406-7322
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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