Provider Demographics
NPI:1669062733
Name:FORWARD MOVING COUNSELING SERVICES, LLC
Entity type:Organization
Organization Name:FORWARD MOVING COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LEAD CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:VIVECA
Authorized Official - Middle Name:L
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-508-3253
Mailing Address - Street 1:2435 DRUSILLA LN STE F
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-1444
Mailing Address - Country:US
Mailing Address - Phone:225-508-3253
Mailing Address - Fax:225-427-8715
Practice Address - Street 1:2435 DRUSILLA LN STE F
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-1444
Practice Address - Country:US
Practice Address - Phone:225-508-3253
Practice Address - Fax:225-427-8715
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-22
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1184978561OtherNPI FOR MENTAL HEALTH SERVICES