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NPI Code Detail

MEDICARE: DEPARTMENT OF HEALTH AND HOSPITALS

MEDICARE: DEPARTMENT OF HEALTH AND HOSPITALS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor015LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1B6214OTHERLABCBSLA

General Provider Information

NPI Number : 1083679955
Entity Type Code : Organization
Provider Name (Legal Business Name) : DEPARTMENT OF HEALTH AND HOSPITALS
Provider Business Mailing Address
First Line : 4800 S GRAND ST
Second Line :
City : MONROE
State : LA
Zip : 71202-6412
Country : US
Telephone Number : 318-362-3339
Fax Number : 318-362-3336
Provider Business Practice Location Address
First Line : 4800 S GRAND ST
Second Line :
City : MONROE
State : LA
Zip : 71202-6412
Country : US
Telephone Number : 318-362-3339
Fax Number : 318-362-3336
Authorized Official
Title or Position : OBH REGIONAL ADMINISTRATOR
Name : MR. MARK DEBORD
Credential : LCSW
Telephone Number : 318-362-3270
Provider Enumeration Date : 04/20/2006
Last Update Date : 05/10/2011

Similar Medicare Providers

1942269394 — CHRISTARDRA MOORE LPC
Practice Location Address:
4800 S GRAND ST
MONROE, LA
71202-6412
Practice Phone: 318-362-3339
Practice Fax: 318-362-3336
1417919416 — DAN T BOUNDS LCSW
Practice Location Address:
4800 S GRAND ST
MONROE, LA
71202-6412
Practice Phone: 318-362-3339
Practice Fax: 318-362-3336
1265496830 — DR. SCOTT ZENTNER M.D.
Practice Location Address:
MONROE REGIONAL MENTAL HEALTH CENTER , 4800 SOUTH GRAND ST.
MONROE, LA
71202-6412
Practice Phone: 318-362-3261
Practice Fax: 318-362-3336
1568427862 — MS. MARY JESSICA DREHER LCSW
Practice Location Address:
4800 S GRAND ST
MONROE, LA
71202-6412
Practice Phone: 318-362-3339
Practice Fax: 318-362-3336
1568564508 — MR. RICHARD H BARFOOT LCSW LAC CCGC
Practice Location Address:
4800 S GRAND ST
MONROE, LA
71202-6412
Practice Phone: 318-362-3339
Practice Fax: 318-362-3336
1588719959 — DEPARTMENT OF HEALTH AND HOSPITALS
Practice Location Address:
4800 S GRAND ST
MONROE, LA
71202-6412
Practice Phone: 318-362-3339
Practice Fax: 318-362-3336

Directions to “DEPARTMENT OF HEALTH AND HOSPITALS ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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