Basic Information
| Provider Information | |||||||||
| NPI: | 1821633942 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CENTRAL LOUISIANA COUNSELING SERVICES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1403 METRO DR BLDG STE G-2 | ||||||||
| Address2: | |||||||||
| City: | ALEXANDRIA | ||||||||
| State: | LA | ||||||||
| PostalCode: | 713013454 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3182304476 | ||||||||
| FaxNumber: | 3182667974 | ||||||||
| Practice Location | |||||||||
| Address1: | 1403 METRO DR BLDG STE G-2 | ||||||||
| Address2: | |||||||||
| City: | ALEXANDRIA | ||||||||
| State: | LA | ||||||||
| PostalCode: | 713013454 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3182304476 | ||||||||
| FaxNumber: | 3182667974 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/13/2019 | ||||||||
| LastUpdateDate: | 11/13/2019 | ||||||||
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| AuthorizedOfficialLastName: | VEULEMAN | ||||||||
| AuthorizedOfficialFirstName: | ZACHARY | ||||||||
| AuthorizedOfficialMiddleName: | T. | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 3182304476 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | LPC | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.