Provider Demographics
NPI:1437555042
Name:LYN HASSENBOEHLER, LCSW COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:LYN HASSENBOEHLER, LCSW COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:LYN
Authorized Official - Middle Name:
Authorized Official - Last Name:HASSENBOEHLER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:225-456-0093
Mailing Address - Street 1:12320 HIGHWAY 44
Mailing Address - Street 2:BLDG 3D
Mailing Address - City:GONZALES
Mailing Address - State:LA
Mailing Address - Zip Code:70737-2202
Mailing Address - Country:US
Mailing Address - Phone:225-456-0093
Mailing Address - Fax:888-494-0963
Practice Address - Street 1:12320 HIGHWAY 44
Practice Address - Street 2:BLDG 3D
Practice Address - City:GONZALES
Practice Address - State:LA
Practice Address - Zip Code:70737-2202
Practice Address - Country:US
Practice Address - Phone:225-456-0093
Practice Address - Fax:888-494-0963
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-10
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA33401041C0700X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA600944303Medicaid