1861938987 NPI number — STRATEGIC COUNSELING SOLUTIONS L.L.C.

Table of content: (NPI 1861938987)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861938987 NPI number — STRATEGIC COUNSELING SOLUTIONS L.L.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
STRATEGIC COUNSELING SOLUTIONS L.L.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1861938987
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/12/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2106 N 7TH ST
Provider Second Line Business Mailing Address:
SUITE 205
Provider Business Mailing Address City Name:
WEST MONROE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
71291-4445
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
318-450-8719
Provider Business Mailing Address Fax Number:
318-314-2158

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2106 N 7TH ST
Provider Second Line Business Practice Location Address:
SUITE 205
Provider Business Practice Location Address City Name:
WEST MONROE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
71291-4445
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
318-450-8719
Provider Business Practice Location Address Fax Number:
318-314-2158
Provider Enumeration Date:
01/12/2017

Additional Information

Authorized Official

Authorized Official Last Name:
SNOW
Authorized Official First Name:
JIMMY
Authorized Official Middle Name:
ALLEN
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
318-450-8719

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  3814 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 600718776 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".




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