Provider Demographics
NPI:1497013676
Name:CHILD COUNSELING ASSOCIATES
Entity Type:Organization
Organization Name:CHILD COUNSELING ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHEERINGA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-669-2322
Mailing Address - Street 1:313 E WILLIAM DAVID PKWY
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70005-3309
Mailing Address - Country:US
Mailing Address - Phone:504-669-2322
Mailing Address - Fax:
Practice Address - Street 1:313 E WILLIAM DAVID PKWY
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70005-3309
Practice Address - Country:US
Practice Address - Phone:504-669-2322
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-25
Last Update Date:2012-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA=========Medicaid