Basic Information
| Provider Information | |||||||||
| NPI: | 1962749275 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | RESOLUTIONS COUNSELING SERVICES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1925 ENTERPRISE BLVD | ||||||||
| Address2: | |||||||||
| City: | LAKE CHARLES | ||||||||
| State: | LA | ||||||||
| PostalCode: | 706016371 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3374295129 | ||||||||
| FaxNumber: | 3372142077 | ||||||||
| Practice Location | |||||||||
| Address1: | 1925 ENTERPRISE BLVD | ||||||||
| Address2: | |||||||||
| City: | LAKE CHARLES | ||||||||
| State: | LA | ||||||||
| PostalCode: | 706016371 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3374295129 | ||||||||
| FaxNumber: | 3372142077 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/07/2013 | ||||||||
| LastUpdateDate: | 11/08/2022 | ||||||||
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| AuthorizedOfficialLastName: | NELSON | ||||||||
| AuthorizedOfficialFirstName: | PEARL | ||||||||
| AuthorizedOfficialMiddleName: | RICHARD | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 3374295129 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | PH.D | ||||||||
| NPICertificationDate: | 11/08/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | N | Agencies | Community/Behavioral Health | 101YP2500X | Y | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Professional |
ID Information
| ID | Type | State | Issuer | Description | 601272922 | 05 | LA | MEDICAID |