Provider Demographics
NPI:1255033460
Name:BATON ROUGE THERAPIE, LLC
Entity type:Organization
Organization Name:BATON ROUGE THERAPIE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SOCIAL WORKER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:WARREN
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:LCSW-BACS, LAC, CCGC
Authorized Official - Phone:504-517-6390
Mailing Address - Street 1:717 S FOSTER DR STE 120
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-5943
Mailing Address - Country:US
Mailing Address - Phone:504-517-6390
Mailing Address - Fax:
Practice Address - Street 1:7732 GOODWOOD BLVD STE 102
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-7680
Practice Address - Country:US
Practice Address - Phone:504-517-6390
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-21
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty