Provider Demographics
NPI: | 1477104727 |
---|---|
Name: | PURPOSE COUNSELING AND MENTAL HEALTH SERVICES, LLC |
Entity Type: | Organization |
Organization Name: | PURPOSE COUNSELING AND MENTAL HEALTH SERVICES, LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | ROCHELLE |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | GIPSON |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MSW, LCSW |
Authorized Official - Phone: | 225-999-2066 |
Mailing Address - Street 1: | 16260 AIRLINE HWY STE D |
Mailing Address - Street 2: | |
Mailing Address - City: | PRAIRIEVILLE |
Mailing Address - State: | LA |
Mailing Address - Zip Code: | 70769-4271 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 225-999-2066 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 11011 CAL RD APT 94 |
Practice Address - Street 2: | |
Practice Address - City: | BATON ROUGE |
Practice Address - State: | LA |
Practice Address - Zip Code: | 70809-2873 |
Practice Address - Country: | US |
Practice Address - Phone: | 225-999-2206 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2019-09-26 |
Last Update Date: | 2020-01-21 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | Clinical | Group - Single Specialty |