Provider Demographics
NPI:1245600295
Name:CONNECTING CONCEPTUAL CONSTRUCTS, INC
Entity Type:Organization
Organization Name:CONNECTING CONCEPTUAL CONSTRUCTS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHAUCER
Authorized Official - Middle Name:
Authorized Official - Last Name:TADEMY
Authorized Official - Suffix:
Authorized Official - Credentials:MPA
Authorized Official - Phone:225-771-8071
Mailing Address - Street 1:PO BOX 80294
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70898-0294
Mailing Address - Country:US
Mailing Address - Phone:225-771-8071
Mailing Address - Fax:225-771-8072
Practice Address - Street 1:4919 JAMESTOWN AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-3228
Practice Address - Country:US
Practice Address - Phone:225-771-8071
Practice Address - Fax:225-771-8072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-02
Last Update Date:2015-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA251B00000X, 251S00000X, 252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health