Provider Demographics
NPI:1932892684
Name:EDDIE ST-VIL COUNSELING & CONSULTING
Entity Type:Organization
Organization Name:EDDIE ST-VIL COUNSELING & CONSULTING
Other - Org Name:EDDIE ST-VIL COUNSELING & CONSULTING
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:FOUNDER & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:EDDIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ST-VIL
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:239-777-4099
Mailing Address - Street 1:616 GREENWICH DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70820-8338
Mailing Address - Country:US
Mailing Address - Phone:239-777-4099
Mailing Address - Fax:
Practice Address - Street 1:616 GREENWICH DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70820-8338
Practice Address - Country:US
Practice Address - Phone:239-777-4099
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-30
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health