Provider Demographics
NPI:1790835544
Name:PERSONAL SOLUTIONS, INC.
Entity Type:Organization
Organization Name:PERSONAL SOLUTIONS, INC.
Other - Org Name:LOUISIANA CRITICAL INCIDENT STRESS MANAGEMENT
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:J.
Authorized Official - Middle Name:DURELL
Authorized Official - Last Name:TUBERVILLE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:318-686-0012
Mailing Address - Street 1:8873 QUIMPER PL
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71105-5620
Mailing Address - Country:US
Mailing Address - Phone:318-686-0012
Mailing Address - Fax:318-686-0012
Practice Address - Street 1:8873 QUIMPER PL
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-5620
Practice Address - Country:US
Practice Address - Phone:318-686-0012
Practice Address - Fax:318-686-0012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2014-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMFT482101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA=========OtherTAX ID NUMBER