Provider Demographics
NPI:1558893594
Name:THE WELLNESS CENTER OF ACADIANA, LLC
Entity Type:Organization
Organization Name:THE WELLNESS CENTER OF ACADIANA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:
Authorized Official - Last Name:SALTZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:337-349-8319
Mailing Address - Street 1:143 RIDGEWAY DR
Mailing Address - Street 2:SUITE 307
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-3414
Mailing Address - Country:US
Mailing Address - Phone:337-349-8319
Mailing Address - Fax:
Practice Address - Street 1:143 RIDGEWAY DR
Practice Address - Street 2:SUITE 307
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-3414
Practice Address - Country:US
Practice Address - Phone:337-349-8319
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-29
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4390101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty