Provider Demographics
NPI:1740399815
Name:PINKARD, TED F (BS, LAC)
Entity Type:Individual
Prefix:MR
First Name:TED
Middle Name:F
Last Name:PINKARD
Suffix:
Gender:M
Credentials:BS, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15110 LA HIGHWAY 16
Mailing Address - Street 2:
Mailing Address - City:FRENCH SETTLEMENT
Mailing Address - State:LA
Mailing Address - Zip Code:70733-2508
Mailing Address - Country:US
Mailing Address - Phone:225-698-6395
Mailing Address - Fax:
Practice Address - Street 1:1112 E ASCENSION COMPLEX BLVD
Practice Address - Street 2:
Practice Address - City:GONZALES
Practice Address - State:LA
Practice Address - Zip Code:70737-4265
Practice Address - Country:US
Practice Address - Phone:225-621-5775
Practice Address - Fax:225-644-2846
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA707101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)