Provider Demographics
NPI:1821571720
Name:KAIROS COUNSELING SERVICES
Entity Type:Organization
Organization Name:KAIROS COUNSELING SERVICES
Other - Org Name:KAIROS COUNSELING SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEGE
Authorized Official - Suffix:
Authorized Official - Credentials:MS,LPC
Authorized Official - Phone:337-278-8193
Mailing Address - Street 1:4640 W CONGRESS ST
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-6622
Mailing Address - Country:US
Mailing Address - Phone:337-210-5844
Mailing Address - Fax:225-214-1655
Practice Address - Street 1:4640 W CONGRESS ST
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-6622
Practice Address - Country:US
Practice Address - Phone:337-210-5844
Practice Address - Fax:225-214-1655
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KAIROS COUNSELING SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-09-07
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TC1900X
LA6343261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA=========OtherAETNA
LA=========OtherCOVENTRY
LA=========OtherLOUISIANA HEALTH CARE CONNECTIONS
LA=========Medicaid
LA=========OtherHUMANA
LA=========OtherCIGNA
LA=========OtherBLUE CROSS BLUE SHIELD
LA=========OtherVANTAGE
LA=========OtherUNITED HEALTH CARE