Provider Demographics
NPI:1508236332
Name:BAYOU COUNSELING SERVICES, P.A.
Entity Type:Organization
Organization Name:BAYOU COUNSELING SERVICES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:COLLIER
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:850-678-1846
Mailing Address - Street 1:222 GOVERNMENT AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:NICEVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32578-1868
Mailing Address - Country:US
Mailing Address - Phone:850-678-1746
Mailing Address - Fax:
Practice Address - Street 1:222 GOVERNMENT AVE
Practice Address - Street 2:SUITE A
Practice Address - City:NICEVILLE
Practice Address - State:FL
Practice Address - Zip Code:32578-1868
Practice Address - Country:US
Practice Address - Phone:850-678-1746
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-06
Last Update Date:2015-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3495101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty