Provider Demographics
NPI:1336348317
Name:SALTER, CHRISTOPHER H (MA,LAC)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:H
Last Name:SALTER
Suffix:
Gender:M
Credentials:MA,LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 E REYNOLDS DR
Mailing Address - Street 2:SUITE H
Mailing Address - City:RUSTON
Mailing Address - State:LA
Mailing Address - Zip Code:71270-2809
Mailing Address - Country:US
Mailing Address - Phone:318-251-4125
Mailing Address - Fax:
Practice Address - Street 1:206 E REYNOLDS DR
Practice Address - Street 2:SUITE H
Practice Address - City:RUSTON
Practice Address - State:LA
Practice Address - Zip Code:71270-2809
Practice Address - Country:US
Practice Address - Phone:318-251-4125
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-11
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1137101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)