Provider Demographics
NPI:1649676016
Name:ANGELS ON ASSIGNMENT COUNSELING SERVICES, LLC
Entity type:Organization
Organization Name:ANGELS ON ASSIGNMENT COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR, CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:RAMONA
Authorized Official - Middle Name:REGENA
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LAC, CCS
Authorized Official - Phone:318-674-0065
Mailing Address - Street 1:1679 S REUNION DR
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71118-2248
Mailing Address - Country:US
Mailing Address - Phone:318-674-0065
Mailing Address - Fax:318-687-1775
Practice Address - Street 1:5537 LAY STREET
Practice Address - Street 2:
Practice Address - City:GILLIAM
Practice Address - State:LA
Practice Address - Zip Code:71029
Practice Address - Country:US
Practice Address - Phone:318-674-0065
Practice Address - Fax:318-687-1775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-13
Last Update Date:2014-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1093101YA0400X
LA3711101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty