Provider Demographics
| NPI: | 1124809389 |
|---|---|
| Name: | BUSH & HILLIARD EXCEPTIONAL CARE COUNSELING, LLC |
| Entity type: | Organization |
| Organization Name: | BUSH & HILLIARD EXCEPTIONAL CARE COUNSELING, LLC |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | OWNER |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | SIERRA |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | BUSH |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | LCSW |
| Authorized Official - Phone: | 225-993-3021 |
| Mailing Address - Street 1: | 147 MOSS HILL TERRACE RD |
| Mailing Address - Street 2: | |
| Mailing Address - City: | NATCHITOCHES |
| Mailing Address - State: | LA |
| Mailing Address - Zip Code: | 71457-6426 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 225-993-3021 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 147 MOSS HILL TERRACE RD |
| Practice Address - Street 2: | |
| Practice Address - City: | NATCHITOCHES |
| Practice Address - State: | LA |
| Practice Address - Zip Code: | 71457-6426 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 225-993-3021 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2023-10-12 |
| Last Update Date: | 2023-10-12 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) |