Provider Demographics
NPI:1023787124
Name:L & A MENTAL HEALTH LLC
Entity type:Organization
Organization Name:L & A MENTAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIC NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:STANCY
Authorized Official - Middle Name:TOMEKIO
Authorized Official - Last Name:COLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, PMHNP
Authorized Official - Phone:318-540-9054
Mailing Address - Street 1:8055 CAPTAIN MARY MILLER DR
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71115-2948
Mailing Address - Country:US
Mailing Address - Phone:318-540-9054
Mailing Address - Fax:318-795-8186
Practice Address - Street 1:8055 CAPTAIN MARY MILLER DR
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71115-2948
Practice Address - Country:US
Practice Address - Phone:318-540-9054
Practice Address - Fax:318-795-8186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-10
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty