Provider Demographics
NPI:1881060317
Name:LHTC PSYCH SERVICES
Entity type:Organization
Organization Name:LHTC PSYCH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BETH
Authorized Official - Middle Name:VERRET
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:337-212-1746
Mailing Address - Street 1:120 GENNA LN
Mailing Address - Street 2:
Mailing Address - City:YOUNGSVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70592-6269
Mailing Address - Country:US
Mailing Address - Phone:337-212-1746
Mailing Address - Fax:855-452-4557
Practice Address - Street 1:850 KALISTE SALOOM RD STE 112
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-4230
Practice Address - Country:US
Practice Address - Phone:337-504-2990
Practice Address - Fax:337-504-5653
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-19
Last Update Date:2020-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP08493363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2406051Medicaid
LA464220Medicare PIN