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
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	005	LA

General Provider Information

NPI Number	:	1750345799
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEPARTMENT OF HEALTH AND HOSPITALS

Provider Business Mailing Address
First Line	:	302 DULLES DRIVE
Second Line	:	SUITE 1
City	:	LAFAYETTE
State	:	LA
Zip	:	70506-3008
Country	:	US
Telephone Number	:	337-262-5870
Fax Number	:	337-262-1272

Provider Business Practice Location Address
First Line	:	302 DULLES DRIVE
Second Line	:	SUITE 1
City	:	LAFAYETTE
State	:	LA
Zip	:	70506-3008
Country	:	US
Telephone Number	:	337-262-5870
Fax Number	:	337-262-1272

Authorized Official
Title or Position	:	OAD REGIONAL ADMINISTRATOR
Name	:	MRS. JOYCE M BEN
Credential	:	LCSW-BACS
Telephone Number	:	337-262-5870

Provider Enumeration Date	:	04/14/2006
Last Update Date	:	08/22/2020

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Directions to “DEPARTMENT OF HEALTH AND HOSPITALS ” Practice Location

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