Basic Information
| Provider Information | |||||||||
| NPI: | 1336603448 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | VILAS & COMPANY LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6002 PERKINS ROAD | ||||||||
| Address2: | SUITE C-2 | ||||||||
| City: | BATON ROUGE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 708084284 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2258315151 | ||||||||
| FaxNumber: | 2253088438 | ||||||||
| Practice Location | |||||||||
| Address1: | 6002 PERKINS ROAD | ||||||||
| Address2: | SUITE C-2 | ||||||||
| City: | BATON ROUGE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 708084284 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2258315151 | ||||||||
| FaxNumber: | 2253088438 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/23/2019 | ||||||||
| LastUpdateDate: | 08/21/2020 | ||||||||
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| AuthorizedOfficialLastName: | VILAS | ||||||||
| AuthorizedOfficialFirstName: | KATHY | ||||||||
| AuthorizedOfficialMiddleName: | R | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 2258315151 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | LCSW | ||||||||
| NPICertificationDate: | 08/21/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.