Provider Demographics
NPI:1659300325
Name:ACADIANA AREA HUMAN SERVICES DISTRICT
Entity Type:Organization
Organization Name:ACADIANA AREA HUMAN SERVICES DISTRICT
Other - Org Name:CROWLEY BEHAVIORAL HEALTH ADDICTIVE DISORDERS CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MENTAL HEALTH CENTER MANAGER B
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:R
Authorized Official - Last Name:KNOWLES
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:337-788-7511
Mailing Address - Street 1:1822 W 2ND ST
Mailing Address - Street 2:
Mailing Address - City:CROWLEY
Mailing Address - State:LA
Mailing Address - Zip Code:70526-4720
Mailing Address - Country:US
Mailing Address - Phone:337-788-7511
Mailing Address - Fax:337-788-7588
Practice Address - Street 1:1822 W 2ND ST
Practice Address - Street 2:
Practice Address - City:CROWLEY
Practice Address - State:LA
Practice Address - Zip Code:70526-4720
Practice Address - Country:US
Practice Address - Phone:337-788-7511
Practice Address - Fax:337-788-7588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-03
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LACCGC# 23101YA0400X
LABCSAC# 478101YA0400X
LALAC# 1070101YA0400X
LALAC# 672101YA0400X
LACCGC# 1003101YA0400X
LAGSW# 61111041C0700X
LARN079104163WA0400X
LA482251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA0010Medicare UPIN