Provider Demographics
NPI:1801489869
Name:MENTAL HEALTH SERVICES OF ALEXANDRIA LLC
Entity type:Organization
Organization Name:MENTAL HEALTH SERVICES OF ALEXANDRIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:GRACE
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:318-787-1301
Mailing Address - Street 1:3600 JACKSON ST STE 117
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71303-3000
Mailing Address - Country:US
Mailing Address - Phone:318-704-0397
Mailing Address - Fax:318-704-0396
Practice Address - Street 1:3600 JACKSON ST STE 117
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71303-3000
Practice Address - Country:US
Practice Address - Phone:318-704-0397
Practice Address - Fax:318-704-0396
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-19
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty