Basic Information
| Provider Information | |||||||||
| NPI: | 1861938987 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | STRATEGIC COUNSELING SOLUTIONS L.L.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2106 N 7TH ST | ||||||||
| Address2: | SUITE 205 | ||||||||
| City: | WEST MONROE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 712914445 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3184508719 | ||||||||
| FaxNumber: | 3183142158 | ||||||||
| Practice Location | |||||||||
| Address1: | 2106 N 7TH ST | ||||||||
| Address2: | SUITE 205 | ||||||||
| City: | WEST MONROE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 712914445 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3184508719 | ||||||||
| FaxNumber: | 3183142158 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/12/2017 | ||||||||
| LastUpdateDate: | 01/12/2017 | ||||||||
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| AuthorizedOfficialLastName: | SNOW | ||||||||
| AuthorizedOfficialFirstName: | JIMMY | ||||||||
| AuthorizedOfficialMiddleName: | ALLEN | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 3184508719 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
| AuthorizedOfficialNameSuffix: | JR. | ||||||||
| AuthorizedOfficialCredential: | LPC | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 3814 | LA | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Professional |
ID Information
| ID | Type | State | Issuer | Description | 600718776 | 05 | LA | MEDICAID |