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INTEGRATED WELLNESS CLINIC OF LOUISIANA LLC NPI 1548602097


NPI Information

NPI: 1548602097
Provider Name: INTEGRATED WELLNESS CLINIC OF LOUISIANA, LLC

Doing Business As: INTEGRATED WELLNESS CLINIC

Classification: Counselor - 101Y00000X
Entity Type: Organization
Address:
10473 OLD HAMMOND HWY
BATON ROUGE, LA
ZIP 70816
Phone: (252) 924-1910
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INTEGRATED WELLNESS CLINIC OF LOUISIANA, LLC is a counselor in Baton Rouge, LA. The provider is a provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification. INTEGRATED WELLNESS CLINIC OF LOUISIANA, LLC NPI is 1548602097. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Integrated Wellness Clinic.

The provider's business location address is:

10473 OLD HAMMOND HWY
BATON ROUGE, LA
ZIP 70816-264
Phone: (252) 924-1910
Fax: (225) 924-1988

The provider's authorized official is Shannon L Boling .
The authorized official title is Operations Office and has the following contact phone number (612) 483-9782.

The enumeration date for this NPI number is 7/25/2013 and was last updated on 4/30/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1101Y00000XCounselorYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
12222222MEDICAIDLOUISIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.